The Day I Learned What “Kill the Nerve” Means & Tips for Handling Medical Issues on the Road

“You have to just…trust me,” she repeated, as she hovered inches from my face with a metal pick in her hand. “It has to be done.”

I had arrived at the dentist’s office that morning. It was roughly two weeks into my stay in Tbilisi, Georgia’s capital city, and a dull pain in one of my teeth had become near-constant.

As I sat on a leather couch in the compact waiting area, a young woman with a dark ponytail of hair, red pants and wide-strap sandals walked in and told me that she would be my doctor. She spoke English, if not fluently, well enough. I was relieved. Georgia’s unique language and alphabet had me stymied for more than a few words.

 

She and an assistant took me to a small closet that was the x-ray room. The dentist said the amalgam filling was irritating the nerve. It needed to be replaced with a composite.

She would not give me anesthesia without an allergy test, so she sent me to a clinic. When I asked for directions, she waved her hand, indicating it was just down the road. I wandered a few blocks until I stopped a man on the street, and he told me the clinic was several kilometers away. Maybe the dentist’s English was not as strong as I thought.

To Kill or Not to Kill (the Nerve)

Two hours later, I arrived back at the dental office. The director of the clinic and my original dentist conversed in hushed tones as they examined a panoramic x-ray I had gotten at the clinic in addition to the allergy tests.

The dentist told me they had to “kill the nerve.” I was having pain at night and in the morning. It was only going to get worse. “Kill the nerve?” I kept asking. She said it was not their preference, but in this case it had to be done. I quizzed her repeatedly about what this meant. “Please try to relax,” she said. “You have to just…trust me.”

I pictured myself on the solo multi-day trek I planned to take in Svaneti and, later, traveling alone through Armenia, another country with a unique language and alphabet I did not know. Reluctantly, I agreed.

She numbed my mouth, removed the amalgam filling and inserted tiny metal pins into the tooth to “kill the nerve.” She used picks to check for blood in the tooth and repeatedly flushed the tooth with water. The bleeding would not stop.

We returned to the x-ray room. She held the film in my mouth with one finger while she stretched fully forward to the computer and typed with her other hand. I needed to spit and made a noise in my throat to let her know. “I know…but you just have to just…find a way…”

When we returned to the chair, I sat quietly, doing my best to allow her to do her work. As she continued, she sighed. “It will be over soon,” she said more than once. “You are tired. I am tired…”

Before I got to the dentist that morning, I was sure the pain was a cavity. The hole, I thought, would be filled in an hour or less, after which I would walk to Pasanauri restaurant for what were supposed to be some of the better khinkali in town.

 

Lunchtime had come and gone. After three hours of work, the dentist took a phone call from someone I presumed to be the director of the clinic and told me that I should go home and come back the next day. She pressed a piece of cotton in the hole in the tooth and told me to change it after I ate. I told her my tooth was hurting. “It can’t be hurting,” she said. “The nerve is gone.”

I went out on the street to hail a taxi, my cheek and lips swollen. The dentist came out and suggested I take something for the pain. She paused. “You don’t know any Georgian?” she said with mild exasperation. “No,” I said.

Meeting My Match and Breaking Away

When I arrived home, I searched online for another dentist in Tbilisi who spoke fluent English. I talked with one on the phone, and for the first time I understood what had been done that day: a root canal. This dentist said she could look at the tooth the following morning.

At her office, an x-ray showed that the nerve had not been fully “killed.” That was the reason my tooth continued to bleed.

Saying goodbye to the first dentist was a bit of a tangled breakup. After I texted her that I would not be coming in, she called me to say that the bleeding was nothing unusual. She could fix the problem. “I just want you to trust me,” she said on the phone and then again when I went to her office to pick up the panoramic film.

Through a series of appointments, the second dentist completed the work. I asked her if she thought the root canal had been necessary, but she did not give me a clear answer.

Whatever the case, I was relieved to be in the hands of dentist number two. She was thorough and funny, quickly becoming one of my all-time favorite dentists. And whether it was the easier communication or her many more years of experience, I had something with her that I never fully had with the first dentist: trust.

 

Doctor Trips: Tips for the Road

I have made doctor visits for minor issues in five countries over the past two years of travels. It can be tricky when you are new in a country and do not have your “go-to” doctor to call on. Here are some ideas to consider if you find you need care on the road:

• Make sure you have health insurance that will cover you as you travel. Surprises happen—I got hit hard in the thigh after a boulder came loose on Kilimanjaro—and long travels can sometimes leave you more susceptible to illness. I use World Nomads. It did not cover this dental work, but it has covered my other doctor appointments.

• When possible, find an experienced doctor with whom you share a common language. If the country you are from has an embassy where you are traveling, you may be able to contact them for a list of doctors who are fluent in your language. You could also check with your hotel/hostel/host or look for expat groups online (e.g., A woman asked for recommendations for an English-speaking doctor in a forum for the Tbilisi chapter of Internations).

• As you would at home, do your own research. At a clinic in Bali, I overheard an Australian woman discussing an appendectomy with her doctor. She seemed to be in for a follow-up visit and had researched the best hospitals in the area as well as the different types of appendectomies available at each one so that she could review them with the doctor.

• Before you leave on any long-term travels, ask your doctors at home if you can contact them in case of an emergency (such as the appendectomy). If they can offer some bit of reassurance or suggest important questions to ask, it may be helpful. Some doctors may be willing to do a Skype appointment if needed.

• If possible, bring someone with you to the doctor. They can be an extra set of ears, think of questions you forgot or listen as you sort through what action to take, if any.

Have you had to deal with any medical issues as you traveled? Do you have any good stories or tips to share?