An ear or a nose?

I am a qualified dental technician. Essentially, I make gums.. and teeth; and everything in between.

However, as soon as the pandemic forced me to spend time alone with my brain; I realised that I was not happy just doing that anymore. I wanted to do something better with myself, to make a difference; to not just stagnate in a job which people break their necks and backs over. I decided that I needed to take a leap of faith. I now don't make gums, and teeth.. but rather - ears, eyes and noses... and everything in between.

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It's an entirely different world. If vulnerability is what makes us human, then these patients are more human than I will ever be. The nakedness takes insane courage to bare, especially in a society as judgemental as today's. Despite building a tough shell outside, inside is still that child wanting to fit in, to not be looked at differently, to not be judged. A child that wants to run away from the cruel words of others, from the free judgement we so keenly use to prey on the weaker ones. He can never run away from the person in the mirror though, and it is the only vessel he's given to carry him throughout this shitshow we call life.

And life decided to underdeliver on that promise as well. There are many reasons why one would be missing an ear or a nose- and none of them are pretty. Accidents, illnesses, conditions, tumours- the list is endless. But the end result is always the same- the patient sitting on our green clinic chair, asking for help.

The first step is a review of the patient. I ask him about his history, and why is he doing it; inform him of what will be happening. Does HE want a prosthesis, or is it because his wife cannot bear to look at him otherwise? Is HE willing to go through all that, knowing that it is a process which needs to be repeated every two years? Is he the one taking all the decisions?

If the answers are favourable, the next appointment is an impression. Using an algae based material which some find cooling but others find distressing; I try and capture the facial features- be it for an eye, ear or a nose. This is the first stepping stone towards a rewarding destination.

The next time I get to see the patient, I'll have something for him. Albeit in wax, I will slowly start delivering on the promise of a facial contour restoration. An ear, or a nose - moulded in pink soft wax, carved, worked, and adapted through the use of hot knives. The patient gets to catch a glimpse in the mirror at the end, but he cannot keep the to-be-prized-possession just yet.

He comes in yet again a few weeks later, and this time he just has to sit still for two hours- maybe reading a book? Praying that sunlight graces the British sky - I paint the soon-to-be silicone prosthesis to complement the rest of his face. Taking advantage of the thick, tacky texture- I add the colours of the rainbow to produce a matching skin tone. If he's British- put more pink! Be careful because they turn red in the sun! Is it afternoon yet? I need to hurry, because the room lighting will make the colour seem all wrong, because of the fancily named phenomenon metamerism, and we definitely don't want that.

And then; two weeks later. The silicone has been cooked, the prosthesis cleaned, and the patient is seated. This is the moment of truth.

I take the prosthesis from the mould, and slowly place it on the patient. Magnets, or gold bars might be there to guide me and help with retention. The decisions taken two appointments ago now come to life as I make sure the prosthesis is seated in the right place. Before I proceed, I need to make sure that the margins- which are the key players in camouflaging the prosthesis, are executing their role properly.

I take my scissors - the straight edged ones, and the curved ones (got to have them all!). I snip away at the margin, bit by bit, trying the prosthesis on and off the patient. Snip, snip, snip, until I get it to where I want it.

The deed is done, and the ear now blends nicely. What we just need is a bit more art to help the silicone come to life. With a colouring palette just like an artist's, I take small brushes and dish sponges, texturising and characterising the surface of the prosthesis. Blobs, dots, freckles; veins and broken vessels- the progressing metamorphosis is beautiful. By the end of the appointment, I'm tired of using my hands, and the patient is tired of sitting down. However, both of us are aware of the reward at the end. Today is indeed the big reveal!

Do we have a mirror? I ask the nurse, knowing full well what a mirror might mean to the patient. The trauma it might inflict, the enemy it might represent. Despite this insight, I place a mirror in front of the person in front of me, offering a silent prayer.

Having heard the words a hundred times does nothing to soften the blow.

"I've forgotten what it feels like to look human again".