3. Patients Defect
Patients Defect
The first cancellation was Danny Obregón, on the Tuesday after Fiesta, and Marisol brought it to me like a dead bird.
"He says he's going across the street," she said. "He says they're doing a free whitening for new patients and his brother-in-law went and got a whole treatment plan for nothing."
"For nothing?"
"For free, is what he said." Marisol's mouth was a line. "Danny's been coming here since he was nine years old, Lila. His mother came here. I taught that boy to floss."
"He'll be back."
"I know he'll be back," said Marisol, "that's not what I'm upset about," and she went and printed the appointment book she doesn't need.
Six the first week. Eleven the second. And they weren't random: they were the sixty-percent, the insurance patients, the families, the people for whom a free whitening and a same-day crown and a smoothie is not a frivolity but the difference between going and not going.
The cash patients stayed. Adele Whitcombe would have gone across that street over her own dead body.
But Danny Obregón went, and the Pruitts went, and a family of five I'd been seeing since my first month went, and each one of them said some version of the same thing to Marisol on the phone, apologetically, because this is a small town and people are kind: they're doing everything same-day, and they said the insurance covers it all, and I can get the whole family in on a Saturday.
The whole family in on a Saturday. I remember hearing that and thinking only about Saturdays.
By the end of the second week Dr. Trinh's Thursday column had gaps in it, and by the end of the third I did something I had not done since the month I bought the practice: I took the loan statement out of the drawer in the evening, with the dog asleep on my feet, and I did arithmetic.
Here's the arithmetic. I bought Santa Barbara Smiles with everything I had left after Beverly Hills plus a note from a bank in Ventura that runs eleven more years.
The building's mine, which means the building's the bank's.
Payroll is Marisol and Dr. Trinh two days and a front-desk girl named Kayla and a part-time assistant.
The month before Luminous opened, we cleared enough that I stopped checking.
Three weeks after, on the trend line I was looking at on a Tuesday night in September, we cleared nothing.
In four months, on that trend line, we cleared less than nothing.
I put the statement back in the drawer.
And here is the part I want to be honest about, because Tess made me be honest about it later and it turned out to be the whole architecture of that autumn: Nate came over that night. He brought dinner. He asked how the week had been. And I said fine.
Fine. That's what I said. I had a loan statement in a drawer six feet away and a trend line in my head and I said fine, and then I asked him about his week and listened to him talk about a title dispute over a Diebenkorn, and I was, I thought, being perfectly reasonable.
Because what was the alternative? The alternative was saying: I am frightened, my practice is going under, the thing I bought with the last of what I had is being taken away from me by a man on a vinyl banner, and I do not know what to do.
Which would have been asking him for something.
I don't ask people for things. I paid off a loan that a man put my name on without telling me, alone, over four years, in a city I hated, and the shape of my whole life since has been never doing that again — and the trouble with that shape is that it doesn't distinguish between a man who lies to you and a man who brings you dinner. It just says: don't.
Tess figured it out in eight seconds flat, because Tess sees my books.
"Your card volume's down thirty percent," she said, on the Thursday, over the cart, with no preamble. "Mine, I mean. My cart. Which means your waiting room is down about a third, which means—" She stopped. Her face changed. "Lila."
"It's a blip."
"Have you told Nate?"
"There's nothing to tell."
"Lila."
"Tess, he's a federal agent on a government salary who rents a house with a bad kitchen," I said, "what exactly would he do? Carry me? It's my practice. It's my loan. It's my problem and I'll—"
"That's the ugliest sentence you've ever said to me," said Tess Okafor, "and one day it's going to cost you about five weeks of your life."
She was off by four days.
Danny Obregón came back on the last Friday in September. Not to book — to ask a question, sheepishly, in the courtyard, with his hat in his hands, the way a man does when he's been somewhere else and feels bad about it.
"Doc, can I ask you something? No charge, I'm not asking for free work, I just — my mom says ask Dr. Bennett." He unfolded a piece of glossy paper. "They gave me this."
It was a treatment plan from Luminous. Beautiful document.
Color photographs of his own molars, a little diagram, a schedule.
And on it, in a neat itemized column, was nine crowns, two onlays, a night guard, and a soft-tissue graft, staged over four visits, with the insurance portion and the patient portion broken out in friendly type.
Danny Obregón is thirty-four years old. I had cleaned his teeth eight months earlier. Danny Obregón had two old composites, mild wear on his lower incisors, and the sturdiest set of molars in Santa Barbara County.
"They said it's all covered," he said. "They said with my plan it's basically free, I just gotta do the four visits. But my mom says nine is a lot. Is nine a lot?"
The courtyard was very quiet. Floss got up from under the table and came and leaned against Danny Obregón's leg, and he reached down and put his hand on her head without looking, the way everyone in this town has learned to.
"Danny," I said. "Sit down. Open your mouth."