I had to go to the dentist. There was an ominous sort of tooth decay happening on my lower gum line. The white tooth enamel faded into a distinct yellowish/gray about 4 centimeters above the yellowish/pink gums. I have been a heavy smoker for the better part of a decade, which probably accounted for all the yellowing. And I never floss which probably accounted for all of the dying teeth.

I had been meaning to go to the dentist for the past three years, but it seemed impossible to raise the money with all the cigarettes I had to buy to quiet my anxiety over not being able to afford a dentist. Eventually, I could wait no longer. The symptoms were getting worse. When I pressed my fingernail into the black area below the lower-left pointy tooth, a spaghetti strand of pain raced from my jaw to my left pinky finger, making my left nipple hard and my left eye twitch. When I pressed my fingernail into the blackened area below the lower-right flat tooth, my right ear would tingle and my right armpit would start sweating. My left nipple also became hard.

There were other complications with going to the dentist besides my pathetic lack of funds. I didn’t have any photo I.D. to hand to the lady (or gentleman) behind the counter when they ask for photo I.D. I don’t know why they ask for this at doctor’s offices, but they always do. What difference does it make if I am who I say I am? It’s not like I’m going to fake a cavity. I’m sure this wouldn’t be a very large complication, but it was another complication nonetheless, and added to my overall anxiety about the situation which forced me to smoke more and make the black parts of my mouth blacker.

What happened to my photo I.D. you ask? A multitude of things. For, at one time, I had multiple I.D.s.  My Texas Driver’s License expired since I never thought to get it renewed when I moved to New York. The expired license (which might have helped me out in some way) was lost in the same wallet containing my NYU card, and my International Student ID card. My passport was also lost, I’m not sure where, but I know it was somewhere in Manhattan. My voter registration card was accidentally thrown away in a drunken night of housecleaning. My Social Security Card was, I believe, handed to a handsome bartender in Nashville with my name and number scribbled on the back. I do, however, still have my ATM card from my bank (it has been replaced three times in the last year) and a laundry card. But I’m not sure either of these would be acceptable poofs of identity.

I threw caution into the wind and made a call to a dentist in Queens.

Hi! Yeah, I would like to make an appointment.”

“When would you like to come in?”

“Well…funny thing. I don’t have any money to pay for the appointment.”

“That’s fine. What insurance do you have?”

“That’s also part of the whole thing being funny, I don’t have any insurance.”

“So, you have no money and no health insurance and you want to come in for an appointment?”

“Ideally, yes.”

“To see a doctor?”

“Preferably”

“No problem. What day would you like to come in?”

“You mean, I don’t have to pay.”

“Don’t be silly. We’ll give you a loan.”

“A loan?”

“A loan.”

“Well, I don’t have any I.D. either to get a loan.”

“You don’t need any.”

I didn’t ask any more questions, for fear of blowing the deal. I booked the appointment, hung up the phone and congratulated myself on being an adult.

I went to the dentist a week later. They took x-rays and examined my rotting incisors (thankfully not recoiling in disgust). After many pokings and proddings and nipple hardenings they were satisfied. A nice, elderly lady in the front office printed out a detailed spreadsheet of all the work I HAD to have done immediately. She said I had eight cavities that needed to be filled and two wisdom teeth that needed to be pulled. The total cost of the work would end up somewhere around $2200. She ran a quick credit check despite my mumbled requests for a second opinion. I was instantly approved, in spite of my embarrassing credit score. I signed a sheet of paper, made an appointment for the following day, and walked out the door.

This part of this our very curious health care system is confusing to me. I had to have ID to get on a plane, buy alcohol, get packages at the post office, drive a car, vote, and write a check. But when I needed a doctor, someone was just willing to give me $2000 and take my word that I was going to try to pay it back. It would almost seem that banks and private moneylenders were in bed with the health care system and they were greedily feeding off the public poverty and their general anxieties brought on by the big drug company’s billion dollar television campaigns to convince the impoverished public that they are depressed and probably have mouth cancer. But I digress.

The next few weeks were a swirl of Novocain and grape-flavored mouth rinse. The highlight was a 250 pound Russian dentist who decided I didn’t need to be put under for the teeth yanking. He literally leveraged himself by placing his foot on my chair and using all of his upper body strength to pull teeth out of my head with pliers. They crumbled under the pressure and the nurse had to shove a vacuum down my throat to catch all of the rotten pieces. When he was done, he asked me why I was crying.

It took me 9 months to pay off the loan. It took me stealing one of my client’s Vicadin to deal with the pain, since the Russian thought I could get through it with Tylenol. What the fuck is Russia all about?

I haven’t quit smoking yet. And I haven’t taken up flossing. Because I have discovered the brilliant economic system of American culture. Give into your vices, and then finance the consequences.