Everything you never wanted to know about dental licensure

This week, for me, was totally consumed with one thought. Boards.

For those who don't know, the field of dentistry (like many other professions) has several hoops that one must jump through in order to actually be a dentist. These hoops start with the classes that must be completed in order to even apply for dental school. I mean really, I am still trying to figure out how Ecology is going to make me better at placing fillings. These hoops continue on through dental school until you get to the end and you are about to graduate. Then there are the BIG FOUR. National Boards. Regional Boards. Graduation. State Licensure.

First, National boards. National boards is a 2-part written exam. The first part is usually taken during, or soon after the second year of dental school and it tests your knowledge of all things non-clinical. You know, things like microbiology, dental materials, dental anatomy, etc. This is the test that, if you want to specialize, you need to get an awesome score on. Please note that this is not because orthodontists or oral surgeons or any other specialty need to have an above-average understanding of microbiology (if anything, it's probably the other way around). Nope. This test is a hoop. A barrier. Something that is totally unrelated to the applicant's ability and is instead there just to narrow down the playing field. But none of this really mattered to me since I "just" wanted to be a general dentist anyway. I took National Boards Part-One during Thanksgiving break of my second year and did fine.

The second part of national boards doesn't come around until the middle of your last year of school. It is also a written exam but is much more practical. It tests your knowledge of clinical procedures as well as your ability to make judgement calls in different situations. I took this at the beginning of my last Christmas vacation, and again, I did fine. It was, I felt, a good test, and really the first hoop I had jumped through that actually made sense.

So, National Boards-Check. Now on to the second of the BIG FOUR. Regional boards. These are the ones that people lose sleep over. There are two main regional boards: The NERB (Northeast Region) and the WREB (Western region). There are others as well, and some states have their own board exam, but most students end up taking one or both of these two exams (unless they are Canadian- they do their own special thing). Since Rachel and I are planning on moving to the West it made sense for me to take WREB.

A little bit about the format of the exam. First of all there is a written portion which I took several weeks ago. It basically tests your ability to make accurate diagnoses and to then formulate an acceptable treatment plan based on those findings. The second part of the test is clinic-based. This is the stressful part. It takes place over two-three days and involves five procedures in three different categories: Endo (you do 2 root canals), perio (1 deep cleaning), and operative (you do 2 fillings). Everything except for the endo is done on live patients (endo is done on real teeth which were extracted).

The reasons people stress about the test are as follows:

1. You are responsible for providing your own patients (and your own teeth for endo)
2. If your patient doesn't show up for any reason, you fail (unless you can hurry and find a backup).
3. If the examiners don't think your patient needs the work you are planning to do, you fail (unless you can hurry and find a backup).
4. There are some things in dentistry that just go wrong sometimes, that are total freak accidents, and that are totally out of the control of the dentist. If these things happen to you, you fail.
5. The examiners seem to be extra nit-picky.
6. If you fail, it costs mega-bucks to make up the exam since it entails paying a bunch of money for re-registration, and then finding patients who have the time, and then paying for all of their costs of transportation, room, and board (not to mention your own) as well as compensation for their time to fly out to a different dental school and re-take the exam.

This clinical portion of WREB took place last week. Let me tell you, I have never felt so much tension in the air as those few days leading up to the exam. Some people were getting physically ill just thinking about it. The crazy thing is that I don't think I have the capacity to get stressed about things. I actually tried to stress about this. I told myself how important it was and how this was pretty much laying everything on the line in a giant all-or-nothing toss to see if the last four years of my life (and a whole lot of money) were completely meaningless. It didn't help. I just could not build up the worry that I was going for.

Even when test day came I felt pretty good, made even better by the fact that my patient for that morning called at 6:15 a.m. to inform me that she was at the school and ready to go (I told her to go and eat breakfast- the test didn't start until 8:00). And really, the test went pretty smoothly. Actually, it went really smoothly. My patients all showed up, they all qualified for the work I was doing, and I didn't run out of time (you know, they only give us 5 hours to do a filling)! On my second filling I was actually submitting my patient for grading before most other people had even been approved to begin the exam. And I feel like I did very well in all sections...except endo.

Yes, one of the root canals I did turned out to be a complete disaster. It was one of those unexpected freak accident type of things that I had no control over and so it was pretty frustrating. For those of you who are dental people, call me and I'll fill you in on the details. For the rest of you, imagine that you put a stick of dynamite inside of a tooth and then lite it. That is pretty much what my tooth looked like. And, for the record, that is not a good thing.

Well, I guess we'll just have to see what happens when I get the results in a couple of weeks. I did an awesome job on the other tooth and they average the two scores together for the root canals, so I may not be out of the game quite yet. And the silver lining is that if I do have to re-take the endo portion I don't have to worry about finding and paying for a patient. Instead, the hardest part may be convincing airport security, with a straight face, why I have a jar of human teeth stowed in my carry-on.

So that was pretty much my experience with WREB. Assuming that all goes well, the next step will be graduation (which will take place in 5 more weeks) and then on to state licensure (really, just a bunch of paperwork). What I am saying is that the hard part is over. I am done. It's all down hill from here. I am going to be a dentist.

And I even picked up a new skill during the process of all of this.

Hoop jumping.

Here I am, relaxing after the exam.

Evelyn went to her friend's birthday party. She wrote her name totally by herself on the card without any guidance whatsoever (I have electronically darkened the letters and inserted arrows to help you read it). We are proud of our girl.

Here she is riding on a manatee at the zoo last week while Rachel was at her interpreting workshop.

This is long. Good luck.

This last week was our Spring Break. It did not seem like much of a break. In fact, the longest amount of time that Rachel and I actually spent talking with each other in person was today on our way home from Columbus. It was a busy week for both of us. It was also a very emotional week for us. But I'll start at the beginning.

Last Saturday evening Rachel dropped me off at the airport. It was sort of sad because just as I was about to go Evelyn looked at me with these big teary eyes and said something to the effect of "you're forgetting to take me on the airplane with you." I explained to her that I was going alone and that I would be back in a few days, but she just didn't understand how I could be leaving her. It was tragic for a little while, but I think she got over it as soon as Rachel distracted her by looking for a "Y" on a sign. I'm not sure what I think about the fact that her daddy can be replaced by a letter of the alphabet.

The next few days for me were spent in beautiful Northern Idaho, looking for jobs and learning about the area. Rachel and I both have this strong "feeling" that this is the place for us to raise our family. Well, we have learned to pay attention to these feelings and after a lot of hard work it was nice to be there interviewing for real possible job positions and looking at real houses and meeting real people. It made the whole thing so much more "real."

My hotel was located in Coeur d'Alene, but most of my time was actually spent a little closer to the border in the Post Falls/Liberty Lake areas. When I wasn't busy with my pre-arranged meetings I was usually driving or walking around the area just picturing our family living there. I honestly don't think that there is any place on Earth that is more beautiful, or more fun, than this area, and I am so excited to move here! (Hopefully). For those of you who want to see what it's like, click HERE to go to a local photographer's web site and see some pictures. Simply beautiful.

So, the results of my visit there are still sort of up in the air. I was offered one job, but we would have a hard time paying back student loans with it. Also, it would probably be a year or more before we would be able to buy a house. Basically, it is less than ideal, but at least we know we have a standing offer. I interviewed at two other places as well in the area, and both of them will take a few weeks to get back to us. One of them would be pretty much PERFECT and we are really praying that we get it. Basically, it is a place where we would be living where we wanted to live, making the kind of money that we were wanting to make, and (for me) doing the kind of dentistry I have been wanting to do. We are REALLY hoping that this works out. The third place I interviewed would fall somewhere in between the standing offer and this other great place. I feel pretty good about my interviews, but there is always that little bit of doubt that nags at you until the final word is said. Anyway- pray for us because if none of these things work out we may be going to Nevada or Texas, and we don't really like either of those options.

A word should be said here about my flight home as well. I was supposed to fly out to Vancouver, WA on Thursday to interview for a fourth position out there. Well, on Wednesday afternoon, just six hours before I was to catch this flight, I got a call from the guy who was helping me set up the interview. "Hey Logan," he began. "I was just calling to see if there was any way we could change the interview location to Yakima." I was flabbergasted. Was he really asking me this. I told him that, seeing as my flight left in 6 hours I was probably not going to be able to change plans. "Well," he said, "would you be able to make it to Yakima today? The interviewer decided to go on a trip and isn't going to be in the Vancouver area." Woah! I again emphasized that my plane was leaving for Vancouver in 6 hours, and that this is where we had agreed to hold the interview, and that I had traveled across the country for this, and that you don't just call a guy 6 hours beforehand to notify him of a change unless it was a real emergency, which this wasn't. This was just plain unprofessional and inconsiderate of my time, not to mention that this trip was costing me a lot of money that I didn't really have to spend on joy rides in airplanes. This was totally unacceptable.

Okay, that's not how I said it, but it sure is what I felt.

As it turns out there was sort of a silver lining to all of this in that the company I was interviewing for agreed to pay for my trip. Also, they set up a time here in Cleveland when I can meet a company representative and complete the interview. The only real downside is that now I had a full day to spend in the airport with nothing to do. Talk about boredom. Wow. But it all worked out, and after a lot of Internet videos and Facebook I finally got on an airplane and met Rachel in Columbus.

Okay, we are going to shift gears a little bit here and Rachel is going to take over now.

Life is wonderful. I have my sweet husband back, my kids are all very healthy, I have had a good dose of interpreting enlightenment... and I lived through the week.

I will start at the beginning. Saturday was a difficult day. I was sick, sick, sick, but somehow I managed to drive Logan to the airport to say goodbye to him so he could fly out to beautiful Coeur d' Alene Idaho for the week. I must have done something really good because on Sunday I woke up feeling miraculously better. Evelyn, on the other hand, was not in the best shape. What followed was four days of constant crying, whining and screaming as Adalie and Jackson decided they, too, felt a little but under the weather (thankfully, not as bad as poor Ev). I have to admit that I did take a moment to myself locked in my room while all three of my kids were screaming. My little quiet moment was very helful in reminding me that, "I love my children, I love my children, I love my children."

Thank you for the little space that I needed to vent.

In all honesty I actually had a very fun week spending time with each of the kids. I had to be very careful, however, because the slightest thing would likely trigger the end of the world (sickness be cursed!). We did a lot of fun activities and played some great games together. I love each of my sweet kids! Evelyn's imagination is taking off, and Jack and Addy are becoming more and more interactive. I also enjoy watching the three of them play together. I am very happy that our kids are so close in age. I love the bonds that are already forming. Oh the rewards of motherhood!

Imagine the following situation. What would you do???

You are on a two and a half our car trip with three kids- for the story's sake lets say that one of the kids just turned three and the other two are eighteen months old. You are the only adult in the car. With an hour and a half to go your sweet three year old announces that she has to poop. You evaluate the situation. There are no trees on the side of the road. It is freezing cold outside. Taking three very young children into a public restroom would be disasterous (use your imagination). What would you do?

It just so happens that I had the opportunity to find an answer to this very question.

I evaluated my options, then I asked Evelyn if she could hold it. She told me that she could. I then crossed my fingers that she wouldn't mention it again. If she mentioned it again I knew I would have to figure something out quick. Thankfully, my sweet girl curled up with her blanket and fell asleep fifteen minutes later. Whew. That could have been a memorable experience.

We arrived in Columbus and we had a great time staying with our cousins Lolly and Doug. I picked Logan up at the airport on Friday morning and I saw him for about 8 minutes as he drove me to the airport Marriott hotel for my interpreting conference. I had a wonderful weekend going to workshops and rediscovering why I love interpreting! I think I have the worlds best job. I discovered a few things about myself this week: I love being an interpreter, I would really enjoy being a mentor, I want to teach workshops one day, I love interpreting, I really love ASL, I am a good interpreter, I love my job, I don't think VRS (video relay) interpreting is for me, and I really love my job. I would say that this was a successful weekend.

On a much different note- I have been thinking a lot about my dad. This week marks the two year anniversary of when he was hit by a car and of when he passed away. I have been thinking about what a great dad he was! I really miss his laugh and being able to talk to him. The hardest part has been thinking about how much he is missing out on not being here to be a grandpa. I am glad that there are so many good stories and memories to tell my kids so that they will have a good glimpse into the kind of person my daddy was. I know I will always be a Daddy's girl.

Okay, shifting gears one more time. This is Logan again and I want to talk about my mom a little bit. Those of you who read our post last week know that we recently discovered that my mom had cancer. She had this big operation last week where they removed half of her colon in an attempt to get the cancer out before it spread. Well, this week we got the report back from the pathology people. And...

Good news!

First of all, the tumor had not ruptured the intestinal lining. This came as a surprise to all since at the time of the surgery it appeard that it had. This also greatly improves the prognosis.

But wait, there's more!

When they did the surgery they disected out several of the surrounding lymph nodes to get an idea of if/how far the cancer had spread. When they ran the tests, however, they found that none of the lymph nodes had cancerous cells in them. Not a single one. The tumor itself was malignant, but it seems like it was a very localized instance and that the whole thing may be over now that the tumor is out. We aren't 100% sure yet, and they have a visit scheduled with the oncologist to confirm things and talk about follow-up care, but every indication shows that my mom has got this thing beat!

I want to personally thank everyone who has been fasting and praying for my mom. As soon as we found out about this my family felt an immediate outpouring of love from so many people and it is amazing what the combined faith and prayers of family and friends can do. I also admire the faith that my mom has shown through the whole thing. She is so amazing.

Like I said, it was a busy, emotional week. In the end I think that everything turned out just the way it should.

It was a good week.

And now that you have read this whole thing, we regret to inform you that there will be no pictures. Sorry. We were pretty much seperated during the whole week so we didn't take any.

After a long, restless night of travel, I am sitting in the Spokane airport this morning. The time is 4:31 a.m. This is 7:30 “my time” so I’m wide awake, but I’m guessing I’ll be pretty beat by the end of the day. During the course of the next 4 days I will go to 4 separate job interviews. Hopefully at least one of them is productive. The other objective of this trip is to make contacts with people who will be able to help us with our move to the area after I (hopefully) get a job. Before Rachel dropped me off at the airport in Cleveland we noted that this next week could be either “one of the most important weeks of our lives,” or it could be a “total waste of time and money.” Tune in next week to see how things turn out.

Anyway, this last week was really good...well, actually I’d like to say that, and for the most part it was, but overall it wasn’t good at all. Before we go there though I have to apologize to Rachel and Evelyn for not including their spectacular date night in last week’s post. Evelyn had a wonderful time at Chuck-E-Cheese’s and came home with a lot of cheap little toys that she won (most of them have since found their way into the garbage- or Jackson’s mouth). We really enjoy this tradition we have started of taking our kids on a one-on-one monthly date and I really hope that we will be able to keep it up as they get older.

So, why was this week pretty much a bummer? That is a hard question to answer, but at the same time so simple to explain. This week we found out that my mom has cancer.

My dad called to tell us while we were on the way to Playhouse Square on a date. We had just realized that the ice-cream shop that Rachel had mapped out for us to eat dissert at was actually an ice-cream factory with no samples, and I was in the middle of teasing her mercilessly for her mistake. When my dad called we jovially talked for a little while about Rachel’s misdirection, but then he said that he was “calling with a little bit of bad news.”

At that point the first thought that went through my head was that our family cat had died. But then I realized that she was already dead. But then I realized that I actually didn’t know if she was dead or not, and that if she was, it didn’t really matter to me. She was a good cat, but I just wasn’t all that attached to her. Then again, maybe I should feel bad that she died, whenever that was, because she was, after all, a part of the family…

So involved was I in trying to remember if our poor stupid cat was still counted among the living that I must not have totally registered my dad’s explanation about how Mom had gone to the doctor and they found a tumor via CAT scan that was about the size of a baseball. I don’t think that it dawned on me the implications of was being said when he explained how the tumor was discovered to be malignant and how the next day my mom would be in surgery having half of her colon removed in a frantic attempt by the doctors to remove the cancer before it had a chance to spread.

No, I don’t think I really realized what was going on at that point, and to tell you the truth I still don’t. The thing is that we have no definitive answers. We know it was cancer, and uring the surgery the doctors discovered that it had penetrated the intestinal lining. Because of this there is a good chance that chemo-therapy will commence soon after the recovery period from this surgery. But we don’t KNOW. The doctors tell us that on Tuesday or Wednesday they will have more answers, but that until then we just have to hope for the best.

I think I am good at just hoping for the best. Another word for it is DENIAL, and I am a master at this. When I get sick I don’t admit it to anyone- not even myself. If the car makes a bad noise I convince myself that I didn’t hear it. And if my mom gets cancer I utterly refuse to believe that it is actually happening until I have irrefutable, concrete evidence that I can’t deny any longer. At least this is what I tell myself.

So what did we do when we found out? We went to Playhouse Square and watched Shrek, the Musical. We laughed and we cheered. We had fun. We HAD to have fun. I FORCED myself to have fun. I have never concentrated so hard on having fun. Because the fact that this actor with green makeup is dancing around the stage making burping noises somehow lets me believe that I am still in control and that nothing has changed since we received that dumb phone call. Somehow, if I can still laugh at this play, then I know that everything will be okay and that the biggest problems in life are about finding ice-cream factories instead of parlors and worrying about a maybe-dead cat who (sorry Sara) didn’t really mean all that much to me.

…But really I am scared.

My mom and dad. Aren't they the greatest?

Here we are at Playhouse Square

Evelyn and Adalie- The two most beautiful little girls in the world!

Right now Addy and Jack are asleep and Rachel and Evelyn are at the kitchen table painting together and talking about what Evelyn learned at church. It is times like these that make me think what a lucky guy I am.

Lately, Evelyn has learned the art of negociation. I make a lot of "deals" with her under my own terms when I want her to do something. Well, Evelyn has caught on and suddenly the tables are turned.

Me: "It's time to clean up."

Evelyn: "How about I read 3 more books and then eat candy and then clean up. Deal?"

Me: "No deal. I said it's time to clean up now."

Evelyn: "Okay. How about I clean up and then read 3 books and then eat candy."

Me: "How about you just clean up and go to bed."

Evelyn: "No deal. How about I clean up and then you read me 1 book and give me candy and then I go to bed, okay."

Me: "Okay, except for the candy part. No candy before bed."

Evelyn: "Okay, then how about I clean up and then you read me two books and then I choose a candy and put it on the table and then I go to bed and then I wake up and eat the candy. Deal?"

Me: "How did candy even get into this conversation?"

Evelyn: "Deal?"

Me: "How about two books but no candy. Final offer."

Evelyn: "Okay."

I'm not sure I'm ready for my children to be this smart. I should just start telling her that "we don't negociate with terrorists." At the same time, I am a little bit proud of her for her quick thought processes and think they should somehow be rewarded. I don't know.

Evelyn also astounded the doctor this week during her check-up. First, the doctor told Rachel that Evelyn should start recognizing some letters by now. Rachel responded, "She recognizes all of her letters, can write over half of them and can tell you the sounds of most of them." The doctor was a little bit skeptical and put Evelyn to the test by giving her a pencil and paper and asking her to prove it. What followed was Evelyn's pure display of genius which left the doctor with her mouth hanging open and struggling to find words. Her quote- "I have a hard time getting five-year-olds to do what Evelyn just showed me."

Just for the record, Evelyn can write 19 letters from memory. The other seven she can easily draw, but has to look at a picture to help her remember what they are. Another facinating little trick she will do is finding letters in every day objects and pointing them out to us ("Look mom, that bridge is an H"). She will also create letters by manipulating objects (food, her body, her sibling's bodies...). Again, I'm not sure I'm ready for such a smart kid, and I hope I can keep up, but I sure am a proud daddy!

On a totally different note, I have decided that we can take all of our toys and put them in storage, leaving only the containers that the toys go in for the kids to play with. I don't think any of them would even notice.

Next subject: Addy the bully. Yep, it is true. From the time she was in the womb she has been taking things from Jackson and pushing him around. Meanwhile, Jack has learned to run the other way as soon as Addy starts making her advance. But then he gets backed up against a wall, and Addy will deck him and take whatever it is he has, leaving our sweet boy a pile of wet, soggy tears. Rachel calls her "Addy, the brute."

Next subject: Jackson is the sweetest boy in the universe (except when he's teething- then he's a monster). When let loose, he will wander around, giggling to himself the whole time, and seek out complete strangers to give hugs to.

Okay, Addy is also very sweet, and not always a "brute," but she definately knows how to throw her weight around. And just so you know, I am not comparing my children. I am merely recording my observations.

Rachel and I had the ultimate window-shopping week. First of all, we had a date night and went to Sears to pick out all of the appliances we will one-day have, from convection ovens to dryers. Sure, that day may not come for another 35 years, but one can dream. Later we went to the Cleveland Auto Show where we looked at all the great cars they have out there. My dream car has stayed the same for years: a big pickup truck (Silverado 2500 diesel). Rachel, on the other hand, upgraded her dreams from a petite little VW Jetta (last year's top pick) to a full-sized Chevy Suburban. And Evelyn wants a Toyota Tacoma really bad. Either that or an ambulance. This came without any encouragement, but I have to say that I am a little proud she would choose a truck, even if it's just because it has a bed that she can easily climb up into and play in.

Anyway, to top off our window-shopping week we looked online at homes that we might consider buying if we had any sort of real income to spend (a fantasy? Hopefully not.) At the end of the week I decided that there are a lot of nice things out there that we can (and probably will) one day buy. But in the end I don't think that any of them can make my life that much better than it already is. Easier maybe, but as I watch Rachel and Evelyn painting at the table I think that there is nothing I could buy to replace that. Even if the reason they are painting is just one of Evelyn's "deals" to avoid nap time.

Here's Evelyn playing in the back of an empty ambulance. With this walk it looks like she should be in an action movie, walking away from an exploding building or something.

Rachel's dream- The biggest car at the show (almost)

Isn't this a beautiful machine?

I forgot to write about this but it was pretty cool. Last week we had an ice storm and there was this 1/4" thick layer of ice all over everything. It was really pretty and I wish I had a better camera to take pictures with. It also made it difficult to scrape car windows.