Philosophy of a wired jaw

Part I

Essentially, getting your jaw wired shut for four weeks causes two things, not simultaneously but in a chain reaction sort of way. The first is the obvious: physical limitations. Talking is no longer your mode of communicating with other people. The only person you can talk to you is yourself – which I can confirm is indeed maddening. The accustomed way of getting food is also gone, leaving you only with one equation instead of the infinite menus and generously stacked supermarket isles. The equation being: eat anything you can squeeze into this little tube. Which leaves only liquids, of course, and even then some of the more viscous soups are excluded. This particular physical limitation of food intake causes a general wearing down of the entire body. Tiredness, fatigue, lack of energy, etc. The nose is now the only means of getting the oxygen the body so badly needs. Its sounds simple enough, but once you’re used to breathing through both your mouth and nose, nose breathing becomes a difficult task, and forget about yawning. Plus, any kind of sniffles or stuffiness now becomes potentially lethal. Your nasal passages are the only way, and so anything that obstructs them can stop your only means of breathing. Some air can pass through the mouth, but it’s so limited that it will necessitate and lead to faster breathing to get more air, something you don’t want to try and rely on with your nose stopped up. A clear nose is a must.

Hunger pangs become as ordinary as meals once were. Even after you’ve drank your “meal”, the hunger still radiates as if the stomach was asking “is that it?” These pangs aren’t hard to get used to once you realize how inevitable they are. The more terrorizing things become the cravings. Your mind races and recalls every meal you’ve ever eaten at home, at every restaurant you’ve ever been to, every bag of buttery popcorn you’ve ever had, and so on. But as with everything, the fact that there is nothing you can do about it allows you to accept it and move on. To try and make up for actual eating, one begins to ponder to oneself, “What is my favorite meal?” A question that is no longer answered lightly with a simple “I don’t know, pizza?” Oh no, there is a very deliberate process behind this question. Tastes are remembered, memories are savored and then compared to each other, one trumping the other as they go.

The face, depending on what was performed on the jaw, may be swollen or without feeling. Either way, the face becomes less expressive than it used to be. A calm, blank, stare takes its place. Don’t forget about the pulsating ticks that the sliced nerve endings emit every now and then and with no warning. The pain reminding you that you are still alive. Pain to tap you on the shoulder and say “I’m still here, I’m a part of this.” In all, the body becomes slow, fragile, weak, incapable of sudden moves or jolts. Feed and rest predominate.

So while there may be others, these are, physically, the main effects of a wired jaw. These, however, do not simply exist in isolation. They are not the end of the change caused by the procedure. As with anything, there is a cause and effect. The cause of these physical changes is the wired jaw. They are an effect of the procedure. Yet they are also the cause of a great deal of effects these physical shortcomings have on the mental well being of the person. This is perhaps the most important effect of the wired jaw. Unfortunately, it’s also the least discussed. Beforehand, people will tell you “oh that will be frustrating”, “oh that is awful”, “oh you’ll lose some weight”, and so on. While they are correct, they will usually add a pitiful comment, attempting be positive in the face of such an ordeal. It’s only meant to make the patient feel better, truth be damned. “It won’t be that bad”, “you’ll have time to read”, “you can relax”, “you’ll get used to it fast”, “four weeks is nothing.” And of course you’ll get the obligatory return stories – everyone has one. “I once had a procedure on my neck and couldn’t sleep on my side for a month.” You keep waiting for them to end all of their stories with “uphill there and back” or something ridiculous for them to prove their point that – while yours will be a tough time – theirs was infinitely worse. People enter into this competition as if having experienced more pain is a comfort to the other person. Other times people just try to make conversation or help people feel less anxious about what will happen. But no one ever prepares you for the effect on the mind. He myriad of things that happen because of the things that they did tell you would happen. Some are good and some are torture. And I am here to tell them.

The first and most obvious problem is communication. You must get used to using your hands a lot, pointing at certain objects to get what you’re saying across. And no you cannot simulate a wired jaw by simply clenching your teeth and talking. Surgery changes everything and it is not that simple. Your eyes and ears will be pointed to a lot – “have you seen?” or “what was that sound?” Of course, an erasable white board is the best way to go, but sometimes you’ll forget it downstairs or some other faraway place, or simply you won't want to rely on it, being a crutch and all does lend to dependency and frustration. This cannot be avoided.

And with regards to these hand signals and motions, realize that, just like any other form of communication, some people will read your signs much better and faster than others. Your father may be finishing your sentences one two three lickety split while your mother seems to be ignoring your hand gestures as she apparently tries to read your eyes instead. She, wanting to prove to herself that she and only she has some sort of superhuman bond with her son that allows her to read his mind by looking into his eyes instead of his hands. Frustration will take over at your inability to scream “Glass of water, of fucking water! Look at my hands and stop staring into my eyes like that! Fucking WATER!” This may be due to outside factors, such as the mother having a complex where she thinks the son does not love her. The staring being her way of proving herself wrong – a doomed enterprise since she will always fail – and something that the son is completely unattached to since all he wants is a glass of fucking water. So communication will be a problem. Beware when you find a sentence finisher (of your signals), although it would seem rational to have that person nearby at all times to expedite anything wishing to be communicated, others will grow jealous and take that connection in good communication to be much more, as if you preferred the other person. What these people fail to see is that you are a patient in a very frustrating position, mentally capable only of feed-related, pain alleviation-related, and bodily needs-related ideas.

The patient should not have to – and shouldn’t even if he notices them – worry about these extraneous and non jaw-related issues. He is exempt, for now. But communication is also blessed once the tables are turned. Listening becomes paramount. Actually, to pass the boredom, some may even find themselves longing for two visitors to simply sit in his presence and talk to each other – all so he can sit and listen – without the attention directed towards him. A wonderful thing happens when a jaw is wired shut an someone is speaking. The expectation of saying something back is completely removed – meaning there is no pressure to say anything back. We can focus entirely on listening to everything the other person is saying without wasting our mental powers scattering to think of how we will respond, what we will say when the person finishes their sentence. This also allows for proper digestion. You can absorb the words, ponder them, and reach a higher level of insight. It’s the difference between sitting down and enjoying a five course meal at a nice restaurant with a little red wine – a two to three hour event – and eating McDonalds in the car on the way to work. There is something gratifying and whole about actually listening. You are not only understanding what the other person is saying, but you are feeling what they are feeling as well. You are sharing a feeling. When the time comes to respond, your answers, advice, comments, will be that much deeper, insightful, and useful to the other person because you know what they were trying to say to you. You felt them. A deep, spiritual connection of sorts has occurred.

Part II

A direct effect of these limitations and fascinations of communication is that the patient will find himself alone most of the time. Sometimes the mindless trappings of television and video games will suffice to pass the time. But when you have four weeks at your complete disposal – even those start to wear on the soul. Boredom takes over. The mind, while may not be completely lucid, begins to wander and wonder.

Pascal tells us that we are wretched, that our lives are wretched, and in order to not think about that, in order to distract us from that reality, we do things like go to school, get a job, read a book, listen to music – anything to keep ourselves busy. Idle hands are the devil’s workshop, and so the patient now finds himself in the very pits of hell with overalls on wondering “this is a workshop?”

When we have nothing to do but look at ourselves and the life we are leading, we realize a few contradictory things. Firstly, yes, maybe Pascal is right in that we stay busy in order to not think about the great questions in life and to not trouble ourselves when we cannot answer them with conviction. “Who am I really?” “Am I being true to myself?” These have all crossed our mind before and the only difference is now we have the time to let them simmer and eat away at our mind. To face them. But eventually, it will all end positively. The patient will look at the life he has led previous to his maxillary bondage and see how free he once was. He will realize the beauty of accepting a random lunch invitation on a Tuesday with an old friend to a restaurant neither have ever been to. It’s only natural, this idea of missing what we no longer have, but the simple prospect of not having the jaw wired is enough to turn the most mundane event into total bliss. Life is wonderful and you love it. Changes are promised once the bondage is removed. Appreciation for food and the other “simple things.” If anything, this pattern of thought leaves the patient in an optimistic state of mind. One of hope and improvement of the self. "As soon as I get unwired..."

Some people say that when a person goes blind their other senses become keener, as if the body automatically makes up for the loss of one sense by improving another. While our taste has been totally removed (the Ensure does taste like – well – Ensure), the spectrum of taste has been violently hacked down to a few select liquids. While ideas of putting a cheeseburger into the blender are common, the realization that one will waste time into a fruitless venture when one could be swallowing nutritional quantities of Ensure keep the cheeseburger experiment at bay. Besides, drinking a cheeseburger? I think not. One thing you will notice is that the sense of smell definitely improves. Which is torture really, when you suddenly realize that the faint whiff of “something” that only you are picking up is the neighbors and their barbeque.

Now you can better smell all the wonderful food you cannot eat. Sometimes ignorance really is bliss. However, smelling becomes the only way you’ll ever taste steak for these four weeks, so why not? It’s been known as an anorexic trick for some time now: “throw the candy bar away, but keep he wrapper and whenever you get hungry just smell the wrapper and you’ll taste the candy bar.” So if it works for them…. And work it will for you will lose plenty of weight also. If you are overweight (or if you are a girl, in which case you all think you are overweight, despite reality), then think of whatever procedure you are having done as a double play. Whatever is wrong will be corrected and as a bonus you will drop some pounds. It’s kind of like a “take home” version of the stomach stapling or stomach bypass surgery. A physical change that guarantees weight loss. Some people even wire their jaw for the primary goal of weight loss, something a person with a wired jaw will recoil in horror at. Voluntarily wire your jaw shut? Blasphemy.

Where has all the willpower gone? But so if you are of normal weight or on the skinny side, be sure to gain some weight beforehand. Even if you do, you will drop down below your “ideal” weight. Your body will change, and though it won’t bother you much when people visit you – since they know what is going on and SHOULD understand, going out in public changes things a bit. Baggy clothing make repeated appearances. Showering takes longer because of the time spent standing before the mirror, naked, looking at the bones you never knew you had that now protrude out into the space that you once occupied. You become withered, less than what you once were. Lankier, bonier, like a curve approaching zero you are bordering on nothing but you don’t quite disappear. Body consciousness does occur, though it is easily masked and not that big of an issue. Especially since you realize that when it’s all over you will have to gain the pounds back. And then it hits you “it’s going to be so much fun.” Your “diet” begins to take shape in your mind. Four meals a day with barbeque chips in between meals. Cheese fondue for dessert and Chili Cheese fries as appetizers. For your health, you tell yourself.

Visitors are a tricky subject. It makes one feel appreciated to receive visits, a sense of being remembered. Visits should be kept short, however (unless there are more than one and they are willing to talk amongst themselves). When one cannot talk it is frustrating, and the board cannot capture all the nuances of what wants to be expressed. So a simple “hello, are you feeling well, I hope you get better, goodbye” is sufficient. It may sound contrary, what with the boredom and all, but it is better to be bored alone than having to contend with the visitors constant stare of “poor you” and the guilt of feeling like a horribly boring person that is boring this kind person who came to visit. As you can see, communication can now be seen as the essential tool that is is in this world of human relationships.

Part III

Sleep becomes increasingly difficult. For those used to rolling around in bed, alternating positions, it will be hard to fall asleep belly up and stay that way. This means the hours of sleep will be cut short. This, coupled with the lack of proper eating and the weakening it causes, gives way to a whole other phenomenon that is rarely – if ever – discussed. One morphs into an image of a wise, old, sage. Slow, very deliberate in his movements, rarely speaking but when he does it is deep and well thought out. Plenty of time to think and be alone with those thoughts. The circumstances are ripe for a re-evaluation of one’s life. What we don’t like and what we want to change. How we could start today if it wasn’t for the limitations of the jaw. All these things accumulate in the course of four weeks, and the whole experience gives us a great opportunity to enact all these deep thoughts of change and personal betterment. Especially when you receive a Toltec book of wisdom as a present that tells us of four basic things we must do to set our true selves free and improve the world around us:

  1. Be impeccable with your word, meaning to only speak when we are fully and spiritually vested in what we are saying. Only constructive , positive things. No poison.
  2. Don’t take everything personally. Meaning don’t think that everything that happens is because of you or for you. Only what happens in you is for you. Don’t be so egocentric to the point of attributing other people’s drama to yourself.
  3. Make no assumptions. Self explanatory, take as true what you know 100% because you were there. Ask questions, don’t be afraid. Do not build on shaky ground, be sure and positive – assume nothing.
  4. Always do your best. This one makes all the other ones possible. No regrets if you gave everything you had at everything you did.

All these mental and physical limitation give the patient a golden opportunity of rebirth. Once the wires come off, you can start over and make great changes in your life. Whether the day will come and normalcy and custom take back the reigns and these ideas are all forgotten matters not, the opportunity was really there for change to occur.

As a young person of twenty-two, one is allowed to feel and think of sex all day, every day. It’s normal and there isn’t anything the matter with it. But under these new physical limitations the overarching, ever-present theme that binds everything we do and think about and want ceases to be sex. By simply wiring our jaw shut we have managed to take one of our most basic human desires that rages on at all times, and turned it off. More like replaced, for now you will see that you still obsess and want and lust and feel like you couldn’t possibly have enough of it. Only this time, sex has been replaced by food. No longer will jokes arise out of someone mentioning a “big banana” or “eating her out”, oh no. Now the mind thinks of them as “oh god what I would do for a banana.” “Eating her out” omits the “her” and becomes an ongoing fantasy of which restaurant to eat out at. Now the reverse happens, where everything is in terms of an edible connotation, even sexual things cease to be sexual and are embarrassingly twisted into something food-related. Food and the infinite spectrum of taste dominates our mind. As far as human desires go, it seems food is more important that fucking, after all. Unless you were to wire my penis down or some horrible thing like that.

Part IV

And so the secondary effects that I had not been told of nor foreseen myself have direct effects, making the whole procedure a bigger deal than simply not being able to talk and eat solid foods. It’s a very big event that can deeply affect our lives. You want to know how to handle it? I believe, eventually, everyone – nix- most everyone will wind up using the same tool to help them through the whole thing: routine. Make an Instant Breakfast shake with two eggs, peanut butter, and some ice cream every morning. One more at 1:30p.m. Then once more before you go to sleep. Hunger can be kept at bay. After each one of these “meals”, clean out your syringe for future use. Then rinse your mouth by passing mouthwash through the syringe. Rinse and when you are done let it all seep through the spaces in your teeth into the sink. Try to spit. It will help to overcome the overwhelming sense of disgust and filth that one feels in both the mouth and the surface of the teeth. Before you get out of bed and before your day is done and you return to your bed, put moisturizer on your lips. They will scratch and peel otherwise. Your tongue can no longer save them from their dry, parching fate. We must artificially do ourselves what the body once did automatically. Get out of the house as often as your weakness allows you. It will help pass the time and fill you with a welcome sense of accomplishment.

One personal thing, get an honest assessment before you get wired from your orthognatic surgeon. A realistic – maybe even worst-case scenario – about how long you will be sealed up for. Make sure if they ingrain you with “four weeks”, then it means four weeks. There is nothing worse that obsessing about having only one more weekend to go and to be told that “no, it will be another week on top of that.” Don’t they realize that we count the minutes as years? Don’t they see that we are like prisoners counting the days and that we have plans to see our families and see the sky and take a bath and walk the streets a free man – to be told so matter-of-factly “nah, another seven years” is both unfair and inhumane?

Keep a journal, write it all down. It’ll be your only friend in which you’ll be able to express the emotions you’ll be experiencing. Catharsis, if you will. You’ll need it now more than ever to surpass that frustrating feeling of wanting to hurt others, for others to know what it’s like. Not to help people who will or are going through it (although a more dishonest man could twist it as so), but to quench the thirst of the little man inside us that yells out as loud as he can “they have no idea!” And the jaw remains in stasis, the lips remain pursed, and the words have nowhere to go but to pile up and wait. So please, write it all out.

Part V

And let’s not forget the inevitable setbacks. When you feel like you are juggling three burning knives with your bare hands and then someone throws in a bowling ball to boot. These setbacks are more frustrating than the rest of it. You can adjust to eating through a syringe. You have time to adjust to not talking. But these are unforeseen circumstances, at least for the patient. Don’t doctors know how fragile the mind is? Don’t they know that four weeks has been imprinted into the patient’s mind? How can the so nonchalantly tell the patient that “oh yeah we’ll probably have to keep you sealed up for another two to four weeks. Yup. Oh and for no particular reason.” What the fuck is that? And this is after numerous inquiries on the patient’s behalf, “so I’ll be free by Christmas?”

“Oh yeah”

Now it’ll extend well into January, thanks for getting my hopes up. This lack of professionalism is rampant in the medical profession here in Guatemala. Doctors seem to think that it’s more important for you to like your doctor than to trust him. This is how they add patients, after all. Word of mouth is the way this society functions, and so they can’t ignore this element of their profession. But they over-emphasize it, leaving the patient in a state of distrust and doubt, “I’m putting my health in this guy’s hands?” Add another mental effect to the whole procedure. Instead, be a doctor first. Worry about treating the patient. If he is satisfied at the end with your skills, it won’t matter as much what you’re like as a person. Tell the patient from the start that it may be four to eight weeks, maybe more. It’s a bummer for sure, but it’s the truth. Prepare him for the worst, you are not an optimistic friend trying to make me feel better. Do your job. I don’t need any forty-year-old dentist friends. I won’t recommend you unless you’re a good surgeon and dentist. This society has made some doctors think they have to be this way. This lowers my confidence in doctors as well as jeopardizing the level of care to be received by reducing professionalism.

Part VI

The first social encounters and gatherings are refreshing. It kind of makes you feel like you are indeed healing. Proof that you are approaching normalcy once more. Ah but underneath it all it can have a negative effect on who you see yourself as being. Jokes cannot be made. Witty comebacks to jaw jokes must be swallowed and no victories are attained. You are an easy target of friendly mockery and ridicule. Oh but you are such an apt attacker on these fronts. You can conquer them all. But alas, the jaw is as thus and defeat is inevitable. You become the quiet kid at the party, seemingly content with simply being there without actively participating. A sad person of low goals and even lower expectations. This is, without a doubt, who you become, and the danger lies (with two to four more weeks) of starting to believe that this person you keep seeing is you. When in fact it is you with a wired jaw. It is you with a physical barrier impeding you from fully being yourself. Know this and remember this, it is important and will be once the barrier is gone, so you can find yourself again quickly and be yourself all over again.


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