Big Girl Teeth
Big Girl Teeth
Why we take animal voyages
“The best trips, like Peter Matthiessen’s search for the snow leopard, find a way to make themselves permanent. A northern white rhinoceros will not come home with you. But your awe at the rhinoceros, your amazement and respect and appreciation — that is portable. …
To return home from an animal voyage is to become, yourself, a new animal living in your old habitat. It is to find yourself voyaging in your own home, waking up to the other creatures that were there all along, inching them from the margins back toward the center of your life, where they belong. It is to remind yourself that being with an animal — any kind of animal, anywhere at all — is its own kind of voyage.”
- Sam Anderson, “Why We Take Animal Voyages”
It’s a long story so I’ll try to keep it short.
The gist is that I had a tumor.
They found it four years ago. Fast forward to now. I’m in Peru, halfway positive that I’ve made a horrible decision by shipping myself to this continent - just depressed in a new city - far away from my dog and my people and every other resource I could sink into normally, specifically - my couch and Netflix account.
They say when you realize you love someone, there’s a particular moment when you just know. Love is like depression in that way. There are many small moments, many tiny data pieces that your brain processes as interesting but not consummate. Supporting evidence but not a conviction. And then suddenly, there’s the conviction: guilty as charged. Depressed. At which point, of course, all of the evidence is undeniable. Hindsight: 20/20.
The final, clinching clue in my Depression Prosecution was the emergency appointment I had, five months ago, at the surgeons office.
That goddamn surgeon and his goddamn office. I will always be grateful for him, for that place, for his skill and ability to fix something very horrible and very wrong and very rare. But god damnit if that place doesn’t put my nervous system into high alert every time I pull into the parking lot.
I was there in an unplanned capacity- the best way to see any medical professional, really. I called them an hour before and they had space. I’m sure they could hear the panic in my voice and also the exhaustion and exasperation. Please help me. This titanium screw you put into my gums last month just fell out while I was drinking my coffee.
I couldn’t be too upset for how long it took someone to come in and see me, since I had so abruptly, loudly arrived with a problem for them to fix. I was waiting in the same room I’d been in countless times before: times I was being operated on; times I was being explained a strange prognosis; times I had sat and examined the X-rays and scans with the doctor (the surgeon) - watching the hole in my jaw morph and shrink by millimeters. Back when they first discovered it, the gaping hole in my bone was so large and expansive that the surgeon told me to stop eating trail mix. “Eating an almond might accidentally break your jaw.” I only recently started with nuts again, four years later.
To be sure, the worst was probably over. This is what I told myself that day or, more accurately, plead with myself (and G*d.) This was simply a minor snafu after all of the other surgeries. After the years of care and daily treatments and CT scans and my insurance not covering a cent. After four surgeries and twelve scans and probably close to $25,000 of bills that, once again, were all out of pocket, and did not count towards a deductible. (The surgeon was not a preferred provider, so my medical insurance covered 0%. Of course, he was also the only provider in the area to deal with this highly specific and rare diagnosis. That detail seemed to be lost on United Healthcare. Their response to my claim may as well have said: Rare tumor? G’fuckyourself. ) Lol!
This particular situation, I attempted to assure myself, in which one of the two titanium abutments on the new posts screwed into my jaw - which would eventually be replaced by shiny fake teeth (crowns) - was probably minor.
It’s hard to feel like it’s minor though, after such a prolonged experience of medical bullshit and fear and not knowing and questioning why me on repeat. Anything feels like it’s the other shoe dropping, finally. Everything is waiting around the corner to get you once and for all. I mean, some tumor was growing inside of you for god knows how long. Waiting to strike. Waiting for you to eat almonds and then shatter your jawbone into pieces mid-bite. Lol! Surprise!
How do you stop looking over your shoulder after something like that? How do you ever feel safe in your body again?
The doctor described the tumor to me like this, in better and more medically-sound terms. It was a tumor, cystic in nature, that formed in the middle of the bone. This kind of tumor, called an Odontogenic Keratocyst - is benign but aggressive (relatable!), and pretty rare- but can form when there are leftover epithelial cells lodged in the jawbone from a tooth yanked out poorly- when some of those cells (tooth-making goo) are left behind in the unforgiving, solid bone. It’s most common in sites where a wisdom tooth was pulled out. But I didn’t have wisdom teeth there. I also wasn’t part of the human demographic where these cystic tumors most often showed up. There was effectively no likely reason to point to that could explain why this little cyst and then giant tumor ever even formed in my jaw.
This is what he said to me four years ago, and I nodded along like I believed him. But I didn’t fully. Because the sinking feelings said something else. They said that this tumor was meant for me. It had traveled through the universe of improbability to find me.
These tumors come from the seed of a cyst. And cysts of any kind tend to grow in size in order to find release in pressure. They get bigger as they try to find a way to reach static equilibrium. The pressure inside of them, compared to the pressure around them, is too great to bear. They need to find a way to reach a lower pressure. A cyst in skin or fat or muscle-mass has less osmotic pressure: the difference in pressure between its insides and its surrounding outsides are not that different. But a cyst in a bone? It’s like a seed planted in a rock. These kinds of tumors grow larger the more pressure is placed on them, in the dark, only becoming more expansive and lengthy in situations where they are refused a way to find a pressure release.
As the cyst tried harder to reach neutrality, it simply busted out the bone around it. That’s how strong it was.
While I waited for someone to come into my room and tell me how my improbable tumor and improbable titanium teeth screws had created an improbable situation whereby I found myself with a screw in my mouth and then in my hand during my morning coffee, I did what I usually do when trying to pass the time. Opened the New York Times.
The news is pretty much off limits at this point in my mental health journey. But I love a good Op-Ed, a culture essay, journalism of experiences and not politics. Cue a reposting of Sam Anderson’s article “Why We Take Animal Voyages” - detailing four trips he’s taken around the world to various animal voyages; trips focused specifically around animals and native wildlife around the world. Icelandic horses. Animal cafes in South Korea. A wildlife sanctuary in Bolivia. Birding in Ghana. Caimans in French Guiana.
I devoured the piece in minutes.
Then, the doctor (surgeon) came in and told me the abutment of one of my posts had come unscrewed. It happens. Rarely, but it happens. It doesn’t mean the surgery went wrong or that I had another tumor. Simply another brick to add to my Wall of Improbables. She hit me with some novocaine and swabbed some numbing cream over my gums, sliced open the pink tissue surrounding the titanium screw, and screwed the thing back in- this time, extra tight. I went home and didn’t have to pay for the visit- one small mercy for the day. I couldn’t stop thinking about the article.
There is much to say about the lore of why this tumor came to be, in the first place. It was very metaphoric- this tumor that grew in silence, in darkness, because the pressure on it to not show itself was so large. It mirrored how I felt internally in many ways. It was the final straw after years of throat and mouth malignancies and illness (all of which were somehow unrelated to one another) that finally stamped in the final message: you need to speak up. You will continue to get sick if you don’t say what has survived and thrived in the darkness.
The metaphor was not lost on me.
Before we knew what it was, I spent a week waiting for the results of the biopsy- waiting for my doctor (surgeon) to call me and tell me whether this surprise tumor was cancer. I spent a week imagining how I would never watch my sister get married or have children; how I would never experience being pregnant; how my parents would bury me long before they died. How doing so would probably kill them, too. People who have never had an experience like this love to tell those of us that do not to worry too much, or not to think of the worst case scenarios. That doing so won’t help.
These people, it becomes immediately and painfully clear, have never been on the other end of a potential cancer call. Best to ignore their advice.
But then, they called. Not cancer.
I was relieved, grateful, and inconsolable. I cried for weeks. I spent the months following not filled with joy, but in a low-level depression. Why me? thoughts sandwiched between This is somehow my fault.
I didn’t want the next rare, unrelated malignancy to be cancerous. I would start to write, finally. I would start to say it all, finally. It would be slow-going, I’d learn over the following years, but it’s okay. I would begin.
What followed were years of treatments: surgeries to place a stent for the cyst to decompress naturally over time; and more importantly- for the bone to grow back. Twice daily cleaning the site with antibacterial wash. Lots of teeth brushing. No almonds. Every six month, another scan- was it shrinking? Was the bone coming back? If I would have had surgery to remove the tumor when it was first found, it would have been reconstructive: melon-balling out most of the right side of my jaw- and destroying what was there to get to it. Bone grafts. Several teeth pulled. Plastic surgery and months of rehab. Instead, my doctor (surgeon) wanted to see if we could create the conditions for the bone to heal itself - so that in time, the eventual surgery to remove the tumor would be less dangerous, less invasive. Hence the stent. Hence the twice daily cleanings of said stent. Hence the 6 month visits. The way he explained this was definitely not in scientific, medical terms - I remember this because of how strangely he said it. “You’re gonna need to be pretty diligent about cleaning this stent. It’s basically just another hole inside of the hole that is your mouth.”
The good news is that Double Hole worked. In the right conditions, my bone slowly grew to replace itself. The cystic lesion decompressed and shrunk. After two years, it was a quarter of its original size. A huge success.
The removal surgery, performed last spring, was also a success. He went in and got the remnants of the tumor, plus some margin. The casualties were my last two molars on the right side- he had to remove them to get good margins, to prevent it from returning. I understood this logically but it was not something I was emotionally prepared for. Drugged and raw after the operation I asked of my teeth, where did you put them? Can I take them home?
No. That’s against policy. That’s a biohazard.
But I grew them?
My whole life I grew those teeth and once they’re out of me they’re a hazard? It felt wrong I couldn’t even say goodbye to them. This felt very true on the drugs and also very true once they wore off. My mouth felt empty. My bone ached wildly for weeks, then for months in a low level pulsing; some strange flavor of grief.
They filled the now-empty hole where the tumor had been melon-balled out with bone graft. It was a cadaver bone, liquified, and mixed with red blood cells collected from my arm the morning of surgery. Cool. It’s like I have a ghost jaw now, I said. Sort of, yeah he said. Over the next year, as the bone solidified and joined my own, small shards of unnecessary pieces would work their way out of my gums: itchy, weird spikes suddenly forming on the smooth pink of my gums. Shards of my ghost bone, poking through and out of the tissue. Also cool.
A year later, after a few more scans, it was determined that my recovery was solid enough to take the next step: new teeth. Big girl teeth. That surgery would be, hopefully, the last. They’d screw heavy titanium posts into my jaw where the ghost bone was. After the posts were in and healed for six months or so, once they’d stuck in and adhered to my bone (ossified) strongly, I could get crowns- two porcelain white fake teeth. I could chew on the right side of my mouth for the first time in four years. I might even eat almonds over there.
In August, they placed the crowns. Four and a half years after the whole ordeal started. Another $3,800 on my card (crowns are considered an elective surgery- they are “cosmetic.” Because, as I’m sure we can all agree, having molars to chew your food is really just about the looks!) Like every step in the process before this, it took time to get used to them - to process and get acquainted with this new step towards my overall healing. The whole time my dentist (not a surgeon) placed them, she complained about how hard it was to get them into place correctly. It was hard to contain my fury, as you can probably imagine. I needed my big girl teeth. I needed to chew and eat trail mix again. I’d been waiting four years for this moment and now my mouth is too small and it’s Friday afternoon and everyone in the dentist’s office really just wants to go home but this is taking longer than expected.
Spare me. I wasn’t going to leave that chair til I had molars again. Eventually she figured it out.
I got my Big Girl Teeth.
I was originally planning to go to Ireland in October of 2024; take the month to explore the country- absorb and learn about the culture, the history, the drinking, straight from the horse’s mouth. My Irish heritage is a huge factor in this tumor; that I was sure of. A culture of denial, of coping, of silence, of loss and grief. In my head, I imagined visiting for a month- working remote the same way I had done in Italy a few years before- and learning once and for all: how much of this grief is mine? And how much of it is my stymied inheritance? The luck of the genetic draw? Buried underground for generations, only to bloom in my small, soft body?
The only problem was that I couldn’t get myself to buy the tickets. Or the airbnbs. Or get my passport renewed. I spoke for months about my plan to visit the homeland, my family’s base and creation point; of understanding myself and my heritage; of tracing back the tendrils of pain to one island in the North Atlantic. I joked about learning, once and for all: am I depressed or am I just Irish? Is my family deeply cursed, or are we Celtic? Funny jokes. Crowd pleasers. And yet- I couldn’t seem to muster the drive to actually make a journey happen.
That is, until May. When I sat in the puffy leather oral surgery chair, my knees pulled into my chest, waiting for the doctor (surgeon) to come in and screw the metal thing back into my gums.
Until I read “The animal has secrets which, unlike the secrets of caves, mountains, seas, are specifically addressed to man,” ... “With their parallel lives, animals offer man a companionship which is different from any offered by human exchange. Different because it is a companionship offered to the loneliness of man as a species.”
I guess I was lonely.
My plan was to tackle this loneliness in the most straightforward way I could summon: journey to the source. Scientific and objective observation. Gather evidence. Prove or disprove a hypothesis. Make my argument. Case closed.
But the loneliness I felt was the kind that didn’t respond to deduction and investigation. Of logic and straightforward treatment. The kind of loneliness I felt, it had now become distinctly clear, was the loneliness of the soul. Am I alone here? Is my suffering mine alone to bear or something different? Does suffering mean anything for anyone? Did I deserve this?
The irony now of course, is that I ever thought I could solve my loneliness by going to live with a bunch of people who mirrored my family of origin. But a journey, a voyage, to see and exist with animals? A place far outside the norms of city travel? Just imagining myself there was already an improvement to my mental state. I imagined a salve of suffering by communing with other animals that had also found themselves in a place of recovery, with a rare diagnosis: being trafficked, or the victim of circumstance, or orphaned from poaching, or rescued from harm. Beings who I would not need to communicate with verbally to absorb each others’ pain; to understand the loneliness and grief we each held.
Now this is all well and good - this story, this surprising yet obvious culmination of events that led to me to abandon my Irish plans and replace them with the South American wilderness. Doing it, however, is a whole other story.
This is how I found myself, sitting in a hole-in-the-wall restaurant in Lima on day one of thirty in South America: doing my best not to hate myself for not knowing a lick of Spanish besides what I remember from Dora the Explorer. What the fuck was I thinking? What the fuck AM I thinking? Should I go home instead? Should I leave early, abandon the idea altogether? I’m here in this city, in a gorgeous loft in the arts district for a few days before moving on to my animal voyage, and I’m still lonely.
Was this a horrible decision?
Sam Anderson, New York Times: “Why We Take Animal Voyages”