17 July: Suffering from sensitivity to cold in my teeth, I saw my family dentist, Dr. J, who after examining all my teeth, could find nothing wrong. The following day, he left on vacation.
26 July : With increasing pain in my teeth and jaw, I went to the Division of Stomatology and Oral Surgery at the dental school, Faculty of Medicine, University of Geneva. After a panoramic x-ray and examination of all the teeth, the origin of the pain could not be identified.
3 August : Visit to the Emergency Room, Geneva’s University Hospital (HUG), where I waited 5 hours to see someone. I was taken up to the ENT Service, then told this was not the place to be and returned to the ER to wait another several hours to be seen by Dr. A. She recommended arranging a consultation with a doctor in the Maxillary-Facial Faculty of HUG, which I refused, just having seen my own dentist and dentists at the dental school. Dr. A could not identify the origin of the pain and sent me home with a prescription for pain-killers.
Note that the ER at HUG is well-known for long waiting periods – just after my experience, a man in excruciating abdominal pain went to the ER only to be told by a nurse who took his blood pressure that he would have to wait 15 hours to see a doctor. Unable to bear waiting that long, in terrible pain, he left HUG, climbing the hill to the nearby Clinic de la Colline to be seen by a doctor who immediately called for a surgeon to operate on him. Diagnosis: peritonitis.
5 August : Suffering from increasing pain, visit to the Emergency Room at the Clinic de la Colline with a wait of 45 minutes. Dr. S prescribed several medications and advised me to see my ENT specialist if the pain persisted "more than three weeks".
7 August : With the right side of my face swollen, loss of feeling in part of the face and lip, and « lock jaw » - barely unable to open my mouth, I saw my ENT specialist, Dr. H, who had me immediately hospitalized in the ENT Service at HUG under the care of Professor Pavel Dulguerov. I was kept 6 days in order to benefit from intravenous antibiotics, anti-inflammatories, and pain medication. A CT scan revealed an empty « abcess » of the peri-mandibular tissue originating from tooth no. 46, a tooth which had received root canal treatment 16 months ago by Dr. J.
A consultation was arranged with a resident in the Maxillary-Facial Faculty who recommended an MRI to exclude an osteonecrosis. Under antibiotic treatment and very tired, I was kept waiting an hour. The resident dug so hard into my gum with a metal object that pieces of bloody tissue fell away and set off terrible pain. Afterwards, I refused to see the resident again and with the permission of the responsible doctor in the ENT Service, I was discharged from the hospital. Two doctors in the ENT Service, including Professor Dulguerov, felt that an MRI was not necessary. Afterwards, I discovered that written in the hospital report were the words “Patient refused MRI” which I contested. Another reason I wished to leave the hospital as soon as possible was because I am electrosensitive. The wi-fi router, covering a very long corridor, was just outside my room. It increased my pain, which the hospital could not control, and caused sleep disturbances.
The one positive side of my hospital stay was the excellence of care of the ENT Service, Unit 3DL. Everyone was very knowledgeable, kind, and compassionate. I communicated this verbally to the mediation service at HUG, which reports to the Director-General, and also had published in the reader comments column of the Tribune de Genève, Geneva's main newspaper, my experience at the ER and a thank-you to the ENT Service. HUG pays close attention to these comments.
9 September: After waiting several weeks for the infection to subside, I was told I could see a dentist for the extraction of tooth no. 46. I could not return to Dr. J and had to find another dentist on my own. Hearing that the Centre-médico dentaire Planète was very good, I saw Dr. S on 9 September. She found that the panoramic x-ray of my teeth done by the University of Geneva dental school was of poor quality. Another one was done, with no extra cost to me, as it was felt this was not my fault. The x-ray showed fractures in the endodontic files in the roots of tooth 46 which had received root canal work by Dr. J. Dr. S told me that it had been negligent of Dr. J not to explain the risks of such root canal work or survey the tooth closely. This took up the whole appointment. The x-ray set off terrible pain once again, due to the uncomfortable position I was forced to be in to have it done and biting down on a hard object. I called the reception to report the pain but the message never seems to have been passed to Dr. S.
17 September: Extraction of tooth 46, actually quite painless, however I arrived in a panic, having suffered too much pain for several months. The young Dr. S was unsympathetic and nearly refused to do the extraction, asking me to return another day. I insisted the extraction be done. Afterwards, I was dismissed with no advice or follow-up other than to hold gauze against the gum to stop the bleeding. Several days later, I received a report from Dr. S saying that, in consultation with their Maxillary-Facial specialist, an MRI should be done. As it was a 2-2 opinion, I decided to have it done and called Professor Dulguerov’s secretary to arrange the appointment. She misunderstood that it was the Centre which was to make the appointment. On 20 September I called her to discover this misunderstanding. She made an appointment for the MRI for 27 September. Results: Image “compatible” – consistent with - an osteomyelitis.
I received the MRI results by Email on Saturday morning, the 28th. The professor being away for two weeks, I phoned the doctor on call in the ORL Service - Dr. H - to share my worry – who was very sympathetic. He contacted the professor who arranged an appointment on 30 September with an expert in root canal complications (Dr. Andrej Terzic) in the Maxillary Facial Service. The news is good : no surgery. Antibiotic treatment for about three months. The doctor said the MRI results were not easy to interpret because the imaging was done too close to the tooth extraction. On my latest visit on 17 October, Dr. Terzic told me I had an inflammation (as opposed to an infection) and that I could stop antibiotic treatment in a few days.
Just before the tooth extraction, I contacted an excellent homeopath at the Bouchet Pharmacy in Geneva. He prescribed phosphoricum acidum for fatigue but nothing to boost the immune system because he said remedies like echinacea are incompatible with osteomyelitis. I also consulted the all-holistic Paracelsus Clinic in St. Gallen, Switzerland about whether they could treat this infection. A specialist replied "no" - that the best course was to keep to the treatment recommended by the Geneva hospital. Afterwards, they suggested I come to the Clinic for reinforcement of the immune system.
To my knowledge, my family doctor, Dr. F, has taken no interest in my health since this all started in mid-July. She is the one who recommended Dr. J, saying she sends her children to him. I have since “engaged” the family doctor of a friend to “orchestrate” future care and treatment, to help speed up appointments and keep health care providers “on track”.
I consider that I have been subjected to a series of incompetence, negligence and lack of responsibility on the part of certain dentists and doctors in Geneva. This has already caused me two months of intense pain and fatigue, cancellation of my summer holiday, incapacity to assume a number of my responsibilities with the NGO I work with. In addition, I find it inadmissible that a hospital emergency room keeps very sick persons waiting for such long periods - with no triage it seems, as is happening time and again, and that a dental school, which trains future dentists, executes such shoddy work.
I have written to the Organization for Swiss Patients (OSP) and a Geneva commission which deals with patients’ rights (part of the cantonal Department of Health), the head of HUG's ER, my lawyer, my insurance company, the head of the dental school, and Professor Dulguerov to apprise them of my “health” experience. I do not expect any replies because the population in Geneva is for the most part passive and anyone who speaks up as I do is taken for "hysterical" or being in the wrong. The Genevois are known for considering their doctors to be Gods and do not question the way they are treated, right or wrong. They have a tendency not to take responsibility for their own health.
On 1 October, the dental school called me to apologize for the sub-standard treatment and x-ray. They offered to reimburse me for the cost of the x-ray and said that they talked to the persons who treated me. They were even ready to do more ... I should have asked them to pay the portion of the hospital bill (not yet received) not covered by my medical insurance! They called again to say that the x-ray machine was not functioning properly on that particular day, a lame excuse in my opinion!
The Director of the Geneva commission for patients' rights contacted me by letter to say that while they are not involved in matters concerning financial compensation, they asked if I wished to bring a complaint against the health professionals mentioned in my letter. Thinking about it, I replied that I would like someone other than myself to let Dr. J know about what I have been through as a result of the root canal work, saying in future that he should warn patients of potential risks and survey teeth receiving this treatment; this should be copied to Dr. F. In the other cases, I explained the steps I took myself directly with the caregivers.
The Director of the Commission replied promptly that I would have to write the letter myself, adding in the text that it was being copied to the Commission. I also copied to my (now former) family doctor. I have sent the letter. In my mind, a non-reply will cry out the guilt of my dentist. My former family doctor is no better in not replying or taking an interest in my health. An example of a conscientious, caring doctor: recently, I sent a health insurance form to Professor Dulguerov's office. He completed it himself and sent it back by return mail with a personal message saying he was glad to know that I was better.
Dr. J. replied to my letter, with a copy to the Geneva dental association. He ignored my point: there was no mention of a dentist's responsibility to warn patients of root canal complications and to survey teeth which have received this treatment.
The OSP contacted me through a very curt Email, commenting that "sometimes it's not possible to find/see the problem from the beginning. The root treatment is always a rescue effort of the tooth." This reply was entirely unsatisfactory, not at all what one would expect from a nation-wide patients' rights group whose head is a member of the Swiss Parliament.
The doctor in charge of the ER ambulatory service wrote me reminding me that the doctor on duty, Dr. A proposed an x-ray and consultation with a specialist in the Maxillary-Facial Service, advice which I refused. Thus, they were unable to provide the appropriate care. They never excused themselves for the long wait.
These last two replies are unsatisfactory. I have had to write a second letter to both. One positive outcome has been the announcement of an increase in staff in the emergency room which should cut waiting time in half for less serious cases of illness or accidents.
On my latest visit with Dr. Terzic in December, he confirmed no operation was necessary, however also that the feeling will not return in the affected part of my face which is a source of discomfort.
In December, my former family doctor, Dr. F, sent me a bill for 60 Swiss francs for several prescriptions I had requested by mail, with absolutely no word of concern for the health nightmare I endured.
For the future, I am seeking out alternative forms of medicine – homeopathic, naturopathy, holistic, because I believe that conventional medicine has failed me.
The Geneva medical profession is for the most part just as lax as its criminal justice system, which was responsible for the brutal murder of Adeline by a repeat sex offender several weeks ago, and other judicial decisions which have returned thieves and violent criminals to the streets a very short time after their trial, only for them to commit - sometimes heinous - crimes all over again. It is ironic that the "Geneva Health Department" (Département des affaires régionales, de l'économie et de la santé) seems to have taken my complaint seriously. The head of this Department "bears a huge responsibility" in the affair of the murder of Adeline because the sociotherapy center which was so lax in allowing a female therapist to accompany the sex offender on the fatal outing, is "attached" (rattaché) to this Department. (See my post, "Portrait of a Rapist and Killer".)
by Meris Michaels
updated 14 January 2014