l - Nobilium

EOWARO
t.
•
10 is sent to you by your Ticonium Laboratory, dodor.
Th e magazine that covers
the whole range of your
interests professional
and personal.
The committee of five men, appointed by the Congress, who drafted the
Declaration of Independence :
BENJAMIN FRANKLIN, THOMAS JEFFERSON, JOHN ADAMS,
ROBERT R. LIVINGSTON, AND ROGER SHERMAN.
-,~ l
THE BIRTH OF A NATION
•
within an hour someone would walk off with the
lamp post!·
Conversation Piece: What insect ranks in usefulness next to the honeybee and silkworm? A small
Oriental insect that secretes the resinous substance
lac, used in varnishes and polishes. . . . The first
description of an inlay was made by a German dentist
in 1834. He used a piece of walrus tusk to cement
into a cavity... . Despite all the information given
to the public via TV and the news media about the
two leading killers, heart disease and cancer, a survey
showed that the public was still generally insufficiently
informed on these subjects. For example, with over
1,600 people questioned, 30 percent couldn't give a
single symptom of cancer and 27 percent didn't even
know a symptom of heart disease .... Are You Busy?
Last year California dentists were sent a questionnaire to find out how busy they were. Of those who
replied, 8,747, a total of 40 percent felt that they were
not busy enough and needed more patients . ... To be
waxed or not to be waxed, that's the question many
are debating about dental floss. From the Journal of
the Kentucky Dental Association comes the observation that although "unwaxed floss is presumed to clean
more thoroughly, there is no evidence, to date, that
waxed floss cannot be just as effective." ... Fruits
with the most amount of sucrose are bananas, peaches,
and prunes. . . . With the high rise in alcohol consumption, the U. S. Department of Transportation
has put out a good pamphlet on the alcohol-related
highway crash problem. Copies are available from
James B. Gregory, National Highway Traffic Safety
Administration, Washington 20590, . and could be
good reading material for your waiting room.
WHY ARE NEW DENTURES lOOSE?
When your impression for a full upper denture was
good (you tried the impression back in the mouth and
the retention was excellent), and the bite was correct,
whose fault is it when the finished denture doesn't
stay in the mouth? Has the laboratory committed
some error in processing the case? Perhaps, but before you start to place the blame on the technician
check these points in eliminating the loose upper
denture:
1. If the patient is wearing an old denture, be sure
that it isn't worn for at least 24 hours before you take
your final impression. T issue tone may not be at best
unless the area is left uncompressed by an old denture.
2. Have patients avoid excessive amounts of fluid
the day before impressions are taken. Unusual
amounts of fluid, especially during the summer,. may
cause tissues to be distended, thus not giving an
accurate impression.
3. If patients have any food allergies caution them
to avoid such foods before impressions are taken, for
here again the tissues may be edematous and give an
inaccurate impression.
4. Take impressions of elderly people in the morning. They are more likely to be free of edema than
they are at the end of the day, especially if they have
kidney or cardiac problems.
DOCTO~ HEAlTHYSE~
Here is some good advice from the Journal of the
American Dental Association of May 1956.
"It seems paradoxical that dentists, engaged in the
preservation of the oral health of the public, often
make inadequate efforts to conserve and improve
their own physical health . ... Certainly, many dentists ... give less thought and care to their own health
than they do to that of the patients. The nation can
ill afford to lose any of its dentists through premature
death. The social loss is particularly acute when it
involves dentists in their fifties, men of experience,
knowledge, and skill. The dentist owes it to himself,
his family, and the public to take every reasonable
precaution to conserve his health and well-being."
10
An award·winning
magaZIne for Dentists,
Dental Assistants, and
Dental Hygienists
Pub ;s ed monlhly by TlCONIUM COMPANY
DIvision of CMPIndustries, Inc., Albtny, New York
Editor
Contributing
Editors
Joseph Strack
Arthur S. Freese, 0 0 S.
Arthu H. l eVI e, D.D.S.
Ma Urice J Teitelba m, D.D.S.
Cover Artist
Edward Kasper
JULY 1976
VOL. XXXV
NO. 7
by Maurice
LADIES AND GE TlEMEN.
THE MAIN EVENT!
T
It ' s ti me to deci de y o ur ro le in th
natio no l e lecti on
CANARIES 1MTHE D£HTAl OFFICE
Not the feathere d vert eb rates, b ut the
ou tst and i n9 pe rso ns every prof ss io n
needs
3
HOW TO DIVORCE AN ASSOCIATE
Ex act ly w hat you shou ld do, an d why .
5
lADY WITHAMISSION
An o ff b e at p iec e b y a tal ented w ri t er.
Tr eat yo urse lf t o a rel axin g, co lo rful to le
from the For East
7
BOOKS
M ost inter sting a nd read able revi ew s,
ta ilor-mode f or Tie reo ders
12
ANGUS AND IMPRESSIONS
A W. C. Fiel ds ' r eport on child d e nta l
p atie nt s; Dento l Th isa an d Da ta ; Wh y
Are De ntur s l o o se ? a nd Docto r, Hea l
Thyse lf
15
An" Arbor M' th '" 481 06
umber t $ U~ ISS 0040 ·671 1> TIC.
C' pyr ght, 1976, Ttcon iU"11 Comp ny, Dil ls Of) of C , P Ind. trt es, Inc.,
York 12207
413 t rth Pearl St, Ai Y
Opt.,o s .' pr..• j bl o" trt b t ors ! TIC do n I nto.t ' tly .. Hett
the \ , 01 t ' e p blislltrs
'·e. .
"CONFIDENTIALLY . . . "
p" ltd 'n U SA. by Jer~y P.rt nti"9 C
An
16
TIC, JULY, 1976
J. Teitelbaum, D.D.S.
CON.TENTS
"'1Sub
r pI," 1. $5 00
TIC, JULY, 1976
Inc , 8.yonn., N J
he political primaries are over and selection of the presidential
candidates this month and next will complete the preliminaries. The
main event is next. We had better prepare for it now.
The November election will be a big one in importance because
our country is beset with serious, and critical, problems-social,
economic, defense, foreign relations, environmental. And some
major medical-dental legislation will be passed next year at the nationalleveL
We have the opportunity and the responsibility to make some input into needed policy-making and problem-solving by voting for,
and Supp0l1ing, candidates whose policies we want to prevail. It is
urgent that we do so, for our private and professional lives are substantially affected by government goals, programs, and actions.
How best to do this? And to do it without adding to the divisivness and difficulties that threaten to characterize this election.
To plunge into the political arena recklessly, without thought of
the consequences to ourselves and our practices, can be as foolhardy and hazardous as remaining aloof and above the battle. Aloofness in matters of personal and national concern is a luxury only
those in the cemetery can afford.
Politics and religion are two subjects that can turn a quiet, sensible individual into a raving, irrational bigot. Obviously, the office
is therefore no place to get into a heated political discussion. But
what can you do when cornered by a patient into declaring your
presidential preference? Suppose you have just given a patient a
local anesthetic and while waiting to begin the preparation of teeth
for extensive bridgework (a lucrative case) the patient starts ranting
and raving about the elections. He is passionately for so-and-so, so
much so that he calls your candidate a " bum." And then he asks
for your opinion. What do you say? When dealing with someone
who is so zealous, tact and discretion are the guiding words. Your
best approach i~ to first placate him With , "You may be right. " Then,
"However, I'm not sure. I really haven't made up my mind yet."
Above all, don't prolong the discussion and treat the moment lightly
by saying, "Well, no matter who is elected, I still have to get these
teeth fixed," then pick up your instruments and get to work.
When the presidential campaign crops up into a conversation, as
it certainly will many times in the months ahead , try to keep it in a
low key . If you feel strongly about a candidate there's no reason
why you can't say so; you may even win a few votes for your party.
But never allow your remarks to evolve into a debate or get out of
control. Try to be selective about the people you talk to. Those who
you know feel as you do will be pleased by your "good" judgment.
I
because the selection firm's premise is unique and its
methods are a sharp departure from traditional paper
and pencil fragmented psychological testing. Selection Research Incorporated (SRI)! believes that if
one wished to separate canaries from a large flock of
assorted types of birds, one only needs to be able to
recognize canaries. It is not necessary to study crows,
cardinals, robins, sparrows, etc. Once one recognizes
canaries, they can be sorted out of the flock with little
difficulty. The same seems to be true of canary people.
What makes this possible is the discovery by SRI
two decades ago that canary people think and talk
differently than less effective people. Canaries' attitudes toward those they serve are different also. These
differences are remarkably more discriminative than
any traits that can be measured by traditional paperand-pencil test methods. When asked carefully
selected open ended questions about people, work,
and themselves, most canaries tend to give similar
verbal responses. By structuring a lengthy, broad
spectrum series of questions, for which canary responses have been identified, it is possible to interview anyone who wishes to be evaluated. By analyzing the tape recorded responses and comparing them
to typical canary responses, it is possible to measure
the comparative strengths of the person being interviewed. When used as a selection device, those applicants giving the greatest number of responseslike pureblood canaries-are considered most likely
to be successful. When used as a developmental aid,
one's comparative strengths and weaknesses can be
compared to the canary profile to locate growth needs
and opportunities. The profile can also be used to
match people who work together so that they complement one another's strengths and work more effectively together.
Each area of strength is referred to as a "life
theme." These themes seem to become well developed
during childhood and adolescence. The themes are
fairly well established by the time one enters college,
and, interestingly enough, present methods of teaching do not significantly alter themes. For instance,
potentially effective teachers can be readily identified
from other college freshmen. Persons likely to be less
than effective' can also be identified, and 4 years of
teacher's college doesn't make them much better. 2
This seems to imply that selection is far more important than training, although, of course, training is certainly still needed, even by canaries. It also implies
that if the term "doctor" literally means "teacher,"
dentistry had best select natural teachers and make
dentists out of them. If it did, the profession would
change dramatically within a decade.
The canary dentist seems to have 14 life themes.
They include mission, health, ethics, ego drive, self
actualization, relator, individualized perception, activator, delegator, conceptualization, sophistication,
4
technology, time binder, and empathy. The auxiliary
profile is not quite as elaborate, but still has nine
themes. They are mission, interaction, rapport, gestalt,
self-concept, activator, empathy, organizational relationship, and continuity.
Most dentists have been selected for the profession
because of a strong technological theme. Assumedly,
they also have a good attitude toward health and
they are, hopefully, ethical. The canary profile bears
this out. In addition, the more successful dentists tend
also to have good ego drive and a marked tendency
toward self-actualization.
However, as research with the profiles has progressed, some interesting theme variations have been
noted. For instance, those dentists who have outstanding preventive practices seem to be better able to conceptualize than their less successful colleagues. The
less successful seem equally as ethical, interested,
sincere, and honest, but do not seem to be able to
conceptualize what it is they are trying to accomplish
in making their practices more preventive. This may
account for the discovery, in a recent survey by the
ADA, that those dentists who felt that they were paid
adequately for the time spent with preventive programs have higher gross incomes than those who do
not feel that they are paid adequately for prevention,
compared to the time it takes. 3 Perhaps those who can
get their preventive programs organized so that patients will accept and pay for them, have also organized the rest of their practices to obtain better
acceptance from their patients.
Of critical importance, from an auxiliary and
patient management standpoint, are weaknesses in the
themes of delegator, relator, individualized perception, and activator. These strengths have not been
sought in prospective dental students, and as a result,
it is common for these specific themes to be weak in
many dentists even though they may score very high
ethically and technically. Dentists with such weak
themes are seriously handicapped. They may have
considerable auxiliary turnover and many patients
who do not accept the high quality dentistry that is
offered them. Unless such a dentist is aware of his
weak themes, he quite likely blames his auxiliaries or
patients (or some external circumstance such as the
community's low dental 10 or its depressed economy) .
On the other hand, if the dentist's weak themes could
be understood by him, and if he seeks adequate growth
and management service, his auxiliaries (or associate
dentists) may be able to help him compensate for his
weaknesses to sharply increase his effectiveness with
personnel and patients alike.
These compensations may be far easier to talk about
than to accomplish. If a dentist's childhood and early
adult experience left him with a weak delegator theme,
he may find it extremely difficult to allow auxiliaries
(Continued on Page 14)
TIC, JULY, 1976
particular interest-even photographs of pre-man's
cavities, how Buddha planted one of his toothbrush
twigs and it became a tree, and much more. A beautiful book.
CHRIST CHURCH, Philadelphia, where Washington
and Franklin worshipped,
and where the latter is
buried in the church cemetery.
Below, Independence Hall,
Philadelphia, w her e the
Declaration of Independence was signed, the Continental Congress met, and
the Liberty Bell is housed.
social and moral." With the dental section written by
Dr. Joseph M. Sim, Assistant Professor of Pedodontics, this book offers a great deal to the dental practitioner who increasingly faces the specialized problem
of handling the teenager whose emotional problems
often show themselves in his oral reactions as he tries
to mature, and whose parents increasingly demand
special consideration for their offspring, who is terribly
difficult to handle at best. Here is much-needed help.
Operating on the Mind, by Gaylin, Meister and
Neville, 224 pp., $11.95, New York, Basic Books,
1976.
The authors are, respectively, a psychiatrist, a sociologist, and a philosopher-the best combination for
those considering the current controversy about psychosurgery. Prepared under the direction of the Institute of Society, Ethics and Life Sciences, this is the
product of some of the leading thinkers in this field.
I have written myself on psychosurgery, so I'm familiar with the unique combination of complicating factors - ethical, neurologic, psychiatric, social - involved here. The final chapter-The Need for Policy
-by a professor of sociology sums up the complexities and societal necessities all of which must be considered. The authors should be proud of this - a
thinking man's book.
The Healing Hand, by Guid Manjoo, 66 pp., ill.
(some in color), $25.00, Cambridge, Harvard University Press, 1975.
Not surprisingly, this book won the Phi Beta Kappa
Award in Science, for this is a fascinating volume by
the Chairman of the Department of Pathology at University of Massachusetts Medical School. Heavily
illustrated in both black-and-white and color, this is
the story of man's struggle to deal with the fruits of
violence, the effort to heal. There's a lot to be learned
here-of how ancient man did right and wrong, even
to using large-jawed ants to hold the lips of a wound
together. And there is a good deal for the dentist's
TIC, JULY, 1976
Murder for Your Pleasure: the whodunits.
Adventure, Mystery, and Romance, by John G.
Cawelti (The University of Chicago Press, 1976,
$15.00) is the how-to of whodunits, Westerns, and
the rest of the "formula" stories. Here are the artistic
characteristics, the archetypal patterns, of the classical
detective stories, the Westerns, and the "social melodrama" (of Irving Wallace). Here are the formulae
as well as their bases in human psychology. Well written, original, and intriguing. Want to write???
Some of the oldies still stand up, and Up for Grabs
(Pocket Books, $1.25) by A. A. Fair (a pseudonym
of ErIe Stanley Gardner) is well worth looking into.
Bertha Cool and Donald Lam are much better than
Perry Mason-for here Gardner escapes the onedimension of Perry Mason stories and brings character and flavor with a good dash of humor to join his
well-laid plots and murder. Good to see A. A. Fair
back. Well worth reading.
Out of Sweden come mysteries by Maj. Sjowall and
Per WahlOo. The Abominable Man (Bantam Books,
95¢) is a terrifying tale of an insane ex-policeman
driven to murderous revenge on an entire police force
in a carefully wrought, brilliant rendition of a troubled
and confused society. Good characterization, realistic,
a real shocker. Exciting thriller!
Bill Knox writes of the Glasgow C.LD. and Detective Chief Inspector Colin Thane once more in Rally
to Kill (Doubleday, $5.95). Mix auto racing, rookie
patrolmen, the battered corpse of a young girl stuffed
in the trunk of an abandoned car, a Peeping Tom, a
hostile boss, and a victim strangled after her death
and you've got another good mystery.
John Wainwright is getting known for his odd plots
and subtle mysteries. Death of a Big Man (St. Martin's Press, $6.95) is no exception. A former chief
superintendent of police in an English county-now
a paraplegic from a criminal's bullet-joins a cabal
of policemen to murder a criminal outside the clutches
of the law. Here it gets complicated, looks as if he
joins the criminal, and then-you'll have to read this
yourself to find the end to a real thriller.
13
How to "Divorce" an Associate
by Joseph Arkin, C.P.A., M.B.A.
Psychosomatic Medicine, by Alistair Munro, 100 pp. ,
$6.00, London, Churchill Livingstone, 1973.
This is a paperback in a series called The Practitioner Library and it is just that, meant specifically
for you and should prove of considerable value to dentists who look beyond the teeth to see the patient
they're treating. Beside Munro, University of Liverpool professor of psychiatry, the contributors represent a broad range of specialties such as surgery, dermatology, and the rest. Well written and broad in its
approach, as Munroe puts it: "There is little, if any,
justification for regarding mind and body as separate
entities." While the chapter on headaches may be
most interesting to the dentist, there is nothing from
which he cannot learn in this modestly priced but very
useful addition to any dental library-interesting and
informative.
The Word Book, by Kahn and Mulkerne, 256 pp.,
$2.95, Be\erly Hills, Glencoe Press, 1975.
This is one of those inexpensive mi ghty mites which
warrant several purchases (for your own desk, your
,ecrctary's, and your home). Not only does it give
you quick spelling for nearly 23,000 words but it also
tells you how to divide th em when you come to the
end of a line; rules for consonants, suffixes, and unusual words; a helpful punctu ation review, and the
mea nings of common abbreviations (from AAUP to
WHO and ZIP) . There are the metric equivalents
and two-letter State abbrevi ations, a dictionary of geographical names, and proofreaders' symbols . Most
practical!
Bodyguard at Lies, by Anthony Cave Brown, 957 pp.,
ill., $ 15 .95, New York , Harper & Row, J 975.
A monumental book, large with necess ary maps and
illustrations-yet I couldn't put it down. This amazing and fascinating story of the intricate deception,
secret agents and double agents, espionage and counter espionage, and cryptanalysis of World War II-
12
despite its length and intricacies-reads more like a
spy thriller than the carefully researched history it
actually is. Not surprisingly, it took this British journalist a dozen years to .write-and it's all there: the
German High Command members who fought Hitler
clandestinely by passing information to the Allies, the
machines that broke the Nazi secret military codes,
the deceits and Montgomery's "double," the heroes
and the rogues, the British decision to allow Coventry
to be destroyed, the armies that weren't there except
on paper or broadcasting, the attempts on Hitler's
life. Here too are Churchill, FDR, Stalin, and De
Gaulle in their strengths and weaknesses, brilliance
and stupidity. Utterly fascinating.
Dentists about to enter into partnership or corporate
practice with an associate often neglect to provide a
means of "divorce" or dissolution. This is one reason
that partnership or corporate buy-sell agreements
often dwell only on the mechanics of a dissolution
caused by death or permanent disability, ignoring the
fact that most joint practices are dissolved by disagreements and conflicts of personality.
Assuming that you are faced with the problem of
how to break up your joint practice in an equitable
fashion, the basic step is to reread your agreement and
see what provisions have been made for dissolution.
In each particular case there will be a different set
of circumstances and generally there will be no easy
answer to the multiple problems faced.
Basically, these are the areas of common concern :
1. Provisions tor settlement of debits of the practice-To protect each practitioner, adequate provision
should be made for the payment of all debts to vendors and filing of final labor and business tax returns.
If the firm has a retirement plan, steps have to be
taken to assure continuation of the trust by transfer
to those individuals who elect to continue the practice.
(See trust agreement for provisions as to transfers to
succeeding interests.) Contracts and leases for rental
of vehicles and equipment and contingent liabilities
are areas where obligations have to be established and
spelled out.
2. Collection at Accounts Receivable-A simple
way would be for the firm's accountant or lawyer to be
designated as a collection agent and notify each patient that outstanding debts are to be remitted to him
as trustee.
The problem here is that some patients will not pay
in full to allow an easy split-up of remaining cash after
payment of debts. In this case the outstanding patient
debts can be assigned to the practitioner who is going
to service that particular patient after termination of
the joint practice. Adjustment will have to be made
for amounts so assigned when distributing the remaining net assets. One problem that can easily be seen
is that of the practitioner who takes on a disproportionate amount of uncollected receivables. He may
very well end up at the short end of the stick if these
debts become in part uncollectible.
Obviously, the dissolution can't be phased out indefinitely as the reason for dissolution is most likely
disagreement. The partners want out and they want
it as soon as possible. Only a Solomon could devise
a foolproof system of dividing accounts receivable to
provide for complete equity.
3. Division of Remaining Assets-After payment
Explorations in Psychohistory, by Robert Jay Lifton,
372 pp. (paperback), $3.95, New York, Simon and
Schuster, 1974.
This book is of particular importance in our presidential election year. Psychohistory is a new psychological discipline, a tool for understanding the psychology of the individual and of history, their interaction and-in short-what makes history tick. This
year, of all recent ones, is the time to look at politicians with this information and in this way. Utilized
to its full, psychohistory might well have spared us
Watergate and perhaps even World War II. This volume offers papers by all the leading practitioners of
this arcane art, including such as Erik Erikson , Robert
Coles, and Kenneth Keniston. Worth reading.
The Adolescent Patient, by William A. Daniel, Jr. ,
456 pp., ill., $22.50, St. Louis, The C. V. Mosby
Company, 1970.
Professor of Pediatrics and Director of the Adolescent Unit at University of Al abama Medical Center,
Dr. Daniels is the ideal authority to do this book, and
his concept is one that demands the cooperation of
dentists: "Our aim is no longer mere absence of disease but the presence of health-physical, mental,
TIC, JULY, 1976
"YEAH, DOC, YOUR ESTIMATE'S READY. WE'RE JUST
CELEBRATIN' IT!"
TIC, JULY, 1976
5
of debts and arrangements for collection of accounts
receivable, the remaining cash is split according to
partnership capital accounts, or corporate shareholdings. This is the easy part.
How do you divide the equipment (office and dental?) Or the leasehold improvements (floor coverings,
electrical wiring, plumbing, decorating, etc.), biologicals, office supplies? And which practitioner gets to
keep the office telephone number?
This latter aspect is all-important. We all know
that people tend to go back to a familiar place; this
very factor is the prime ingredient in the creation of
good will. They tend, too, to call a number already
known to them and listed in their personal directories.
Perhaps the fairest way is for all members of the
firm to open offices in another building, giving up of
the phone number, and selling all of the equipment to
a dealer or by private sale through classified advertising.
This may be spiteful, may even be malicious, but
even if one practitioner offers to pay for the leasehold
improvements and pay a fair price for the equipment,
the fact remains that he'll have the edge in keeping
riot only those patients assigned to him but attracting
those assigned to other retiring practitioners-and
he'll have first crack at all new patients.
The library can be offered for sale and if no agreement can be reached as to who will be permitted to
buy it, a price can be predetermined and a drawing
held to select a buyer. Or a sale can be made to an
outsider. Biologicals and other supplies can be split
up among the practitioners or sold to them or to outsiders.
4. Splitting up the Patients-A big asset in any
practice is the income-producing factor, in this case
the patients being served.
Where two or more practices were merged to form
an entity, it is possible to assign the patients to the
dentist who brought them into the practice. Of course,
inequities will result if, through the ordinary contingencies of life, some patients have died, moved to
other cities, or simply changed dentists. Or, where
there was a cash adjustment at the outset for differences in amount of gross income, adjustments will
again have to be made.
To even things off in any split-up, new patients can
be used to balance the scales of equity. But, it must
be kept in mind that patients are not chattels and they
may not want to be "palmed off" to one particular
practitioner they really don't like. This human factor
has to be taken into account when deciding which
practitioner gets which patient.
An agreement has to be entered into providing that
patients will not be pirated.
All x-rays and patient records will have to be trans-
6
ferred according to the agreed-upon division. Note
that ethical factors and state law may come into play
if there is an attempt to even off patient load by assignment of patients.
5. Division of Staff-It is a recognized fact that
every professional practice spends countless hours and
a lot of money to properly train staff members.
In any break-up it follows that each practitioner
will want to retain trained and experienced help.
Again we may have a serious problem and certainly we don't want to force an employee to work for one
practitioner as opposed to another. Yet, we can't
afford to get into a bidding situation where one practitioner will try to outbid the others and thus hope to
retain certain staff members.
If no settlement can be reached, the only solution
is to let each staff member pick the person for whom
he or she wants to work. An agreement for salaries
offered not to exceed 115 or 125 percent of the latest
salary paid can be an alternative to a bidding situation.
If any items in this article have disturbed you, now
is the time to dig out your agreement and see if there
are major deficiencies.
The time to take care of these matters is when you
are friendly with your associates and no ill-feeling
exists. Once you reach the point of getting that "divorce," it is too late. Animosity will cloud clear thinking and only tend to place additional obstacles in the
path of providing for an ordinary, orderly dissolution
of a professional practice.
139 SE 3rd Street
Hallendale. Florida 33009
:Da\.\OWCk
"NO, I DIDN'T START ON A SHOESTRING . PA
GAVE ME TEN BIG ONES."
TIC, JULY, 1976
drill. And, naturally, they just can't afford to have
x-rays taken of their teeth. Regardless of the nature
of their ailment, when they come to my dispensary
I make it a point to inspect their teeth. I probe every
tooth with an explorer, and then make a simple drawing of upper and lower jaw, specifying by numbers
the teeth that need attention. This I give to them,
and I try to scold them into going to the dental clinic
in Kowloon. They promise, but, of course, they don't."
She continued: "Gum diseases are the major cause
of tooth loss among the adult Shui-jen. There seems
to be considerable wasting away of the bone supporting the teeth among these boat people, which is because they neglect their diseases of the gums and
periodontal tissue. When they come here, and I see
that they have impacted food particles and heavy dental tartar or plaque, I scrape away as much as I can.
But, as I say, my scope is limited. I just don't have
the equipment."
I commented: "1 should imagine you have a difficult time with one of these husky Shui-jell women
and men when you clamp onto a tooth and start pulling."
"Yes, they come only when the tooth is giving them
considerable pain and its pulp completely decaycd.
You can hear them yowling for miles. When there's
a particularly bad one, I tell Bill's wife to play the
organ loudly in the Proclaiming Light classroom so
the entire Yaumati Shelter won't think murder is being committed here.
"Fortunately, I've never had any tooth or bonc
fractures. I try to be as careful as possible, making
sure of a solid hold before starting the extraction.
I do apply a local pain-killer to the gum area of the
offending tooth, but it doesn't do the job completely.
Well, in the early days of the West, the barber- dentist gave his victims a shot of whiskey, which 1 can't
do here. Anyway, I have some pain-killers to give
my patients afterwards which lessens the after-effects
of the extractions, and I've been able to control bleeding to a minimum."
"Do you think later you might go in for more
sophisticated dental care for the Shui-jen?" I asked.
Ethel shook her head. "No, these people are just
not conditioned for such attention, involving partial
dentures, filling of cavities with silver amalgam,
crowning and capping of teeth with gold, the use of
synthetic porcelain and plastic, root canal work, or
occlusal reconstruction. That is work for a modern
dental office ashore. Eventually, as the children of
the Shlli-jen become more educated, they will become
more concerned about dental hygiene and care. But
the old folks will only come to my dispensary when
they can't stand the pain of a toothache any longer.
So for now it'll just be for what I do."
With the fairly recent interest in acupuncture in
America, I inquired if Hong Kong dentists were using
TIC, JULY, 1976
this therapeutic method in modern dental offices.
Ethel nodded: "Almost 300 years before the birth
of Christ they were using gold needles for various
diseases, and they were also applied to the gums and
teeth."
She smiled over a sudden thought. "When I get a
particularly apprehensive dental patient for a rugged
tooth extraction, I use a bit of psychology. The Shuijell do have a spartan side to their character. They
face death at sea in typhoons in the China Sea many
time. But having a tooth pulled seems to overawe
them. Therefore, I feel I must bolster them up, make
them feel ashamed of their anxieties and cringing
away from the forceps. So I tell them the story of
Apollonia, the so-called patron saint of dentistry who
was tortured by having all her teeth broken or knocked out because she refused to renounce her religion.
She was threatened with being burned alive, but before her persecutors could cast her into the fire she
threw herself into it.
"And that story makes them ashamed of their uproar over a single toothache?"
Ethel nodded: "You might say it gives them a stiffer upper lip."
Ethel has not had an easy time administering medically and spiritually to the Shui-jen.
"It isn't a simple effort to convert the Chinese Shuijell to Christianity and approved modern medicines
and techniques. They have had for centuries traditional religious beliefs and established Chinese medicines, remedies as old as civilization itself, every sort
of weird powder, ointment, tonic, and pill that might
be compounded of such things as dried monkey
hearts, dried entrails of lizards, parings of tiger claws,
and so on. There's a lot of what you might call sorcery and mumbo-jumbo in their medicine.
"However, although the Shui-jen might be steeped
deeply in Chinese traditions where medicine is concerned, they can tell the symptoms of approaching
death in a loved one. When an otherwise doomed
person is snatched away from the brink of death.
merely by the sudden injection of a hypodermic
needle, then they open up their minds to modern
medicine. Our medical care, free to them, is our
means of public relations, of reaching them, of gaining their primary trust, so they will come to our Proclaiming Light and listen to the words of the Christian
faith."
Sometime later, Ethel Groce left the Yaumati Boat
Mission, and gave her attention to the roof-dwellers
of Hong Kong, most of them refugees from Communist China.
The world is a much better place for such as she.
P.O. Box M
Honolulu. Hawaii 96815
II
down here to Kowloon, running a barrage of Communist machine-gun fire."
What a saga that must have been! Mming at a
snail's pace, traveling mostly by night, hiding by day
in small coves and inlets, to escape Communist river
patrols.
When she joined me in the living room, physical
signs of her exhaustion were erased. She was a slender, attractive woman of medium height, and she
looked years younger than her actual age. Her skin
\ 'as smooth , the eyes behind the glasses serene and
very blue, the mouth gentle, the jaw, however, strong.
The quality that impressed me immediately about this
"lady with a mi ssion" was that here was a woman
who had found a fully rewarding career to which she
could give complete dedication.
"My first post in China was in early 1938 in the
leper colony of Tsing Yuen in the Province of Kwantung, outside Canton. When the Japanese invaded
China, I reported for work at the Presbyterian Hospital in Lin Shien, about 150 miles northwest of Canton, where I remained until October 1944. At the
close of World War II, I was ordercd back to America. But they couldn't keep me there. In July of J 946
I was back in Hong Kong on my way to Canton.
There I found that the mission boats had been taken
over by the Japanese, used as barracks, and then
scuttlcd in 1943.
"The Chinese Communists drove us out of Canton
in 1949. But when we left, the Proclaiming Light
came with us." Ethel smiled softly upon the ancient
cumbersome craft with its open top verandah and
diminished belfry containing the swinging metal cylinder for summoning the students to class . "I have a
great sentimental attachment for that old tub."
The Dental Health Scene
I was especially interested in the scope of her dental work in the Yaumati Junk Shelter, especially because she was not a dentist.
"My forceps must be at least 50 years old, but it
does the work," she said, smiling. "And, believe me,
when I've finally extracted a molar from one of these
Shui-jen you can be sure my back and arm muscles
ache. Their teeth must be the biggest and the most
deeply imbedded of any race in the world. But, then,
dentistry is a gruelling occupation.
"Basically, their diet is good, rather heavy in calcium from their fish-diet , but they sometimes lack
some of the assimilative vitamins, such as D in conjunction with calcium, so I hand out a lot of special
calcium pills. The prime teeth problem of the Sllllijen is that they just won't come here or go ashore for
a regular checkup, and using a brush and dentifricealthough China invented the bristle toothbrush in the
15th century-is not one of their daily habits. So,
although their dental health is quite good, they just
won't attend to any cavities. The idea of having a
tooth drilled frightens them. I guess they've heard
too many stories about howls coming out of a shoreside dentist's office over the loud whine of a burred
A YOUNG SHUI-JEN GIRL ACTS AS RECEPTIONIST IN THE DISPENSARY ON DR .
GROCE'S HOUSEBOAT. THE FAITHFUL LIGHT.
10
TIC, JULY, 1976
LADY
WITH
A
MISSION
A pair of old forceps, a small medical kit, a Bible,
and an indomitable will to help others made her famous among the "boat people" in the junk shelters of
Hong Kong's harbor.
Text and Photos
by Wilmon Menard
N
a dentist, or physician, has had a more challenging and interesting group of patients than Ethel Groce ,
the "Lady with a Mission." So, before I introduce
you to Ethel, let me tell you about her patients-"the
sea gypsies of the South China Seas."
I first saw the "boat people," or Shui-jen, of South
China from the bridge of a Norwegian freighter that
was approaching the rocky islands guarding the entrance to Britain's Crown Colony of Hong Kong. The
flotilla of junks and purse-seiners suddenly appeared
between the island passages, like a Ming armada,
careening high-pooped crafts, the same today as a
thousand years ago, with their huge single lug-sails
flapping in the variable wind. Some showed the white
wake of auxiliary marine-engine propulsion.
Captain Anhart, the skipper, handed me his binoculars, remarking: : "Fishing junks manned by the best
seamen of the Orient-the 'water people,' sometimes
called 'the sea gypsies of the South China Seas'."
I brought one of the junks into sharp focus , and I
could see the family activity on deck-men, women,
and children moving with effortless precision to perform primitive nautical duties older than the Norsemen's. Women squatted over galley-stoves in the stern
or on the poop; young boys were handling lines or
repiling nets on the foredeck; six-year-olds were sluicing down the decks with small buckets of sea water.
The "master," grandfather or father, stood immobile
aft, a figure of celestial patience, with his hands on
the relic helm. Everyone had a duty to perform.
As the freighter moved up the heavily trafficked
harbor of Hong Kong, I saw that the vessels moored
to buoys in the center of Victoria Harbor were crowdTIC, JULY, 1976
DR. ETHEL GROCE MAKING HER ROUNDS.
ed with small junks and one-masted lighters, the aristocrats of the Shui-jen, who enjoy a measure of social
respect and status depending on the type of cargo
unloaded into their holds or on deck for discharge
ashore. The sampans of beggars and sea-going peddlers moved slowly along the flanks of the cargo ships
that flew the flag of every nation; young, pretty Shuijen girls, with glistening black braids swaying to their
motion, sculled in close, smiling, and waving to attract the attention of seamen.
The wide roadstead between Kowloon and Hong
Kong Island was congested with Chinese craft-of
every conceivable design and color of sails-that were
being guided or yuloh-ed (stern-sculled) with a long
sweep) on seemingly erratic courses, contending for
routes with the incoming and outgoing freighters and
passenger vessels, or the criss-crossing Star Ferries,
calculating the margin of clearance so finely that one
wondered there was not a serious collision. I later
learned that the sea gypsies of Hong Kong purposely
cut close to larger ships, particularly of a foreign flag,
because they believe that they could pass their badluck demons onto a pass ing vessel , which sometimes
can result in serious rammings.
Once ashore in Hong Kong one of my first interests
was the Shui-jen, and I learned that they were not
pure Chinese, but ancient aboriginal descendants of
the Orient, who never settled ashore. They have always manned sea-going junks and controlled deep-sea
and coastal fishing. Ancient laws once forbade them
to step foot on land, to inter-marry with those of the
land, or to be eligible for the Imperial Examinations
to educate themselves. But during the reign of K' ang
Hsi (1662-1721) the land ban against them was mod-
"1
ified slightly, and they were then permitted to build
shacks along certain waterfronts. However, acquiring an education and intermarrying with land people
were still taboo.
Even tod ay the Shui-jen are disinclined to settle
ashore, and hold an inherent suspicion and distrust
of land people. They have a saying: "We always sail
away from land troubles."
There has been no official census taken of the Shuijen for a long time, because refugees from Communist
China at one time came en masse to the junk shelters
of Hong Kong, down the Pearl River to Macao, and
then on to Hong Kong and Kowloon. But a fair estimate is that there are close to 225,000 Shui-jen in the
Crown Colony shelters, half of them fishermen, the
rest engaged mainly in trading voyages, and cargo and
passenger transportation.
I was to spend many days being sculled among the
watery labyrinths, formed by the moored junks and
sampans of the Yaumati Junk Shelter on the Kowloon-side of the bay, which is within walking-distance
of most hotels in Kowloon . Wide open channels run
the length of this "floating world," bisected with narrow waterways. Junks are strange crafts, with their
ancient bamboo-ribbed, accordion sails, lofty poops,
broad hulls, and flat keels. But many of them have
come safely through the worst typhoons of the South
China Sea. Pigs and poultry are raised aboard the
junks, dogs romp on deck, and cats chase one another
in the rigging; a fiery red rooster perched on a rail is
a familiar silhouette, extending himself to flare his
neck feathers and scream a challenge to another cockerel on an adjacent junk.
Sampans and bum-boats deliver fresh water, firewood, vegetables, and other groceries; there are floating drydocks for scraping and repairing hulls; they
have a coffin-maker (the Shui-jen, as with all Chinese
people, are always given interment ashore), a yodelling postman, an ancient fortune-teller, and an aquatic
doctor to dispense mysterious pills, powders, fluids,
and sundry elixirs to the ailing. The Shui-jen also
have their schools in their fioating world. And their
recreation-junks for eating, drinking, and gossiping
with each other. There is, also, a double row of sampans in one water-way, the red-light district, where
pretty Shui-jen prostitutes sit in the stern to entice the
roving males of the Junk Shelter. And all the junks
and sampans have their Buddhist and Taoist shrines,
with burning joss sticks and effigies, rice-paner prayers, and the ancient and revered family tablets.
The more time I spent among the Junk Shelters of
the Shui-jen, my admiration and respect for them increased because of their happy, industrious, patient
dispositions which permitted them to live in primitive,
close-packed harmony aboard their crafts. Everything is shipshape aboard, even though every inch of
space is taken up by family members of several gen-
8
erations. The scenes of routine actIVIty are always
pleasant: the mother, whom everyone worships,
squats with her daughters tending open-galley fires,
scrubbing pots, ladling water or soup, washing rice,
chopping up food for quick-cooking, combining, in
the invention of centuries-old recipes, aromas more
subtle and mouth-watering than a Cordon-Bleu chef.
The father, or the grandfather, the master of the craft,
attends to, and overseas, major repairs and adjustments to rigging, sail, and seine, an eight-year-olddaughter spreads washed clothes over a boom to dry,
at the same time keeping a vigilant eye on a crawling
infant to be sure it has not slipped its waist-cloth and
line and is in danger of falling overboard; the youngest son sweeps down the deck. All without bickering,
interference, or carelessness .
The floating"world of the Shui-jen is a complete
one.
The Shui-jen, through their self-governing councils,
dispense order, charity, and justice with meritorious
wisdom. They are extremely law-abiding, and this
might be attributed to their reluctance to become involved in shore-side intrigue and mainland laws. Their
only legal rebuke from the land seems to stem from
overloading their crafts with passengers, or when they
accidentally collide with another junk or sampan.
Even then, although the Harbor Master will sit in on
the resultant hearings, they settle such problems in
their own manner and time, with a strict code of
etiquette.
STARTING THE EXTRACTION PROCESS WHILE THE
TIENT'S SON STANDS BY APPREHENSIVELY.
The Lady with a Mission
Then I heard about Ethel Groce and her old pair
of dental forceps.
A British journalist, with whom I was having cocktails at the Peninsula Hotel in Kowloon, remarked:
"There's a country-woman of yours, a medical missionary, doing a great job among the Shui-jen people
in the Yaumati Junk Shelter here. She lives among
them in a houseboat."
The next morning I was up early and in search of
Ethel Groce. The Chinese woman sculler threaded
her bum-boat through the watery alleyways between
the junks and sampans, and at last she pointed out
the mission boat.
From some distance away, the Chung Kwong. or
Faithful Light, toward which the Shui-jen woman was
ferrying me, appeared to be a small godown, or warehouse , on pilings among a cluster of sampans. When
I came closer I saw that it was a shipshape houseboat,
with blue hull and double-storied white superstructure. Moored alongside was another older houseboat,
the Chinese characters designating it as the Po Kwong,
the Proclaiming Ligh t, which my ferrywoman informed me by gestures was used as a school classroom
and Sunday school. Sampans of converts were crowded all around the two houseboats.
In the modern dispensary of the Faithful Light
houseboat I found Ethel Groce, well beyond middleage, who at my entrance had a hammer··lock on the
head of a howling Shui-jen woman who was about to
lose a huge molar.
•
PA-
TIC, JULY, 1976
DISTRIBUTING CALCIUM PILLS TO THE CHILDREN.
TIC, JULY, 1976
"Yes, yes, I'm a dentist, too!" Ethel called to me
over her shoulder. "I never thought when I was specializing in obstetrics at the Presbyterian Hospital in
Chicago that I'd be called upon to pull teeth. Well,
one lives and learns, and it helps to be adaptable, especially out here in the Far East." She took a stronger
grip and started tugging again. "Make yourself at
home , and I'll be with you shortly."
I wandered out on the open landing-deck of the
Faithful Light, and through the open windows of the
adjoining school bo at I could see a crowded classroom
of young children, sons and daughters of the Shui-jen,
lustily singing a Chinese nursery jingle. They were
led by a dark-haired American man, blowing hard
upon a shiny trumpet, the valves seemingly manipulated by a small monkey, a clever puppet-glove he
had slipped over his hand.
Ethel called to me from the doorway of the dispensary's waiting-room, "That's Bill Kinkade tooting
the trumpet. His relative Florence Drew organized
in 1909 wh at was to become the Oriental Boat Missions."
She motioned me to follow her to the upper story
of the houseboat. I saw that her once-immaculate
white uniform was spattered with blood; there was a
trace of weariness in her face. As we climbed the
stairway, she said: "I had over 50 patients this morning, running the gamut from a splinter in a big toe to
a suspect case of spinal meningitis. Anything major
or critical, of course, I must send to the British Government clinic in Kowloon. There were five gum infections and three rough extractions, particularly so
that my instruments, forceps, scalers, and explorers
are cast-off items, perhaps from the Ark.
"The Shui-jen are a rugged race, immune to many
common diseases, but they still present an exhaustive
medical problem , especially so that I must supply
medicines, serums, anti-biotics, vitamins, and dress~
ings free of charge, and a lot of it I'm compelled to
buy on the retail market here in Hong Kong."
She excused herself to wash up and change her
uniform. The living room of the houseboat, in which
she left me, had rattan furniture, the cushions were
covered with gay tropical-flowered material, and
bright curtains fluttered in the windows. There was
a table lamp with a base made from an abacus, and
Chinese metal filigree artwork was arranged on the
walls.
"The keel of this houseboat, the Faithful Light,
was laid April 1, 1957," Ethel called from her bedroom. "The money to build it came from all over
America-$10,000 in all. She was built here in the
Kowloon shipyard, and was launched June 29, 1957.
The school houseboat, the Proclaimin g Light, was
raised from the mud of a river near Canton and towed
9