An Accidental Dentist

Growing up, I always enjoyed “making things”: models, modifying bicycles (built three), and eventually working on sports cars. So, when it came time to go to college, I chose to attend an engineering school.

Belonging to a good Catholic family, I had five siblings—two of whom were already in private colleges. My father suggested I apply to the Coast Guard Academy since it provided an engineering degree and came with a full scholarship. I went through an interesting admission process that included having all my fillings changed (at my parents’ expense).

During Easter Break of my senior year, I was working at my father’s company when I was supposed to go to the final interview, where you get your appointment. My father’s business partner came up to me as I was leaving and said, “Paul, I know that you are under a lot of pressure to accept this appointment. But before you do, you need to take a long look at the ocean and make sure it is calling you.”

I drove to San Pedro and was surprised to find the Coast Guard Station on a hilltop overlooking the LA harbor and out to sea. I climbed up the stairs and, remembering Mr. Rice’s advice, stood there looking out at the ocean. Unfortunately, there were no mermaids calling!

I went in, and the interview went well. But when it came time to commit to a career in the Coast Guard, I told the officer that I could not do that at this time, though I was willing to give it my best and had no issues with the required service time. The result was an alternate appointment and the instruction to go to college for a year and reapply if I was still interested in the Coast Guard. He guaranteed I would get the appointment.

Now what to do?

It was the spring of my senior year of high school. My father went into action, and I was accepted at Notre Dame and Duquesne based on the USCGA status. But I didn’t want to go back East. So, I pleaded my case.

He then asked, “Where do you want to go?”

I went blank. Then, remembering the Rose Bowl game that year, USC popped into my mind. I was accepted into the School of Engineering as a late admission. That decision profoundly changed the course of my life.

Happily ensconced in engineering school, I was shocked to see a Time magazine cover story featuring a taxi driver in Seattle with the caption, “Do you believe this guy has a master’s degree in Aeronautical Engineering?” One of my classmates brought up the article during a design class. The professor asked if the article bothered us. There was a consensus of yes.

So, he decided to go off curriculum and explained the life cycle of an engineer. He emphasized that if you don’t transition into management by your mid-forties, you will become not technically obsolete but economically obsolete.

My roommate and I went back to the dorm and agreed that we were screwed.

We both decided it was important to learn about this “business management thing.” We went to the counseling center and were advised that, thanks to our engineering math curriculum, we had surpassed the requirements for a degree with an emphasis in Quantitative Business Analysis in the Finance department. Both Denis and I eventually got our MBAs. Denis became a Harvard-educated attorney.

While this was going on, I met a cute blonde girl in my chemistry lab—and her roommate in English. It took them a few weeks to figure out I was the same person. You know the blonde: Gail, my wife. Another random decision—to take a Friday lab and discussion—created this encounter and life-altering event.

During my senior year, I took the DAT and scored well, so I applied to USC Dental School. I had an interview, and the dean explained that although I had great test scores, due to Vietnam he had a file drawer full of applicants who had taken all the “right courses.”

I explained my logic: Dentistry is a business. Answer: Yes. I went to business school to learn about business. Then I thought I would come over here and learn about dentistry. I understand doctors make a lot of bad business decisions. Answer: I see your logic, but I can only offer you an alternate admission.

Now, with the draft breathing down my neck, I decided to take the GMAT. Luckily, I scored well and was accepted with advanced placement to GSBA, so I was within one calendar year of getting my MBA. (That provided me with an additional student deferment.) So, I continued my finance studies.

In late fall, my dad asked what I was doing about dentistry. I told him, “Well Dad, they didn’t want me—so screw them.” He told me to reapply, but also to apply to Creighton, where a friend of my brother-in-law was a student and very happy with the clinical experience—especially compared to a friend at one of the California dental schools.

By spring of ’69, I received my draft physical notice and decided to enlist in the Navy Finance Corps. I was accepted and received instructions for a final interview. I also received an acceptance from Creighton the same week.

During that week, I was sitting in the back row of a Capital Budgeting class pondering which direction to take with my life. The class was discussing a case study from industry. The manufacturers’ names were hidden, but it was clearly one of the Big Three auto makers.

It involved a dispute between the finance department and the engineering department. The task was to determine—using a statistical confidence interval—the “sweet spot” when you reduce engineering standards (making vehicles less reliable) versus the increased cost of warranty claims.

One of my classmates said he thought this was unethical. The professor responded that while he saw our perspective (being products of the ’60s), our job as analysts was only to make the calculations. Management would make the decisions.

So, I thought: Wow. Am I going to spend my life being an agent of mediocrity—or go into dentistry (micro-civil engineering to me) or enter the Navy?

A few days later, I went to the Navy interview and got a minority officer. His questions, in order:

  1. What do you think about your sister dating a Black man?
    Answer: That is really my sister’s business.

  2. What do you think about interracial marriage?
    Answer: I think it’s difficult for both parties due to cultural differences causing problems with acceptance in both families and cultures.

  3. Do you think you can supervise Black men?
    Answer: Yes. I think when you demonstrate competence and treat people fairly and with respect, they’ll respond to your direction.

  4. What do you think about affirmative action?
    (Me thinking: What do any of these questions have to do with me sitting in a cubicle crunching numbers? This guy is a first-class jerk. Time for some fun.)
    Answer: I’m all for giving people opportunities, but it’s sad when they’re wasted. I don’t see you guys over at the School of Engineering or the Science Department or in the Business School. Instead, I see you over in the Sociology Department studying your navel. That won’t take you anywhere.
    Him: How dare you talk to me like this!! (Red-faced, slams hand on the desk.) I control your future!
    Me: No, you don’t.
    (Being a good grad student, I reached into my briefcase, pulled out the Creighton acceptance letter, and said: “Talking to you has made me decide to become a dentist.”)
    His face went blank.
    I walked out.
    I became a dentist.

Wolf, wolf. End of shaggy dog story. Beginning of a great adventure.

Most Memorable Adventure in the Clinic

Spring of senior year, I was working radiology. Susman had stepped out. A pretty young lady came up from oral surgery with an order for a PANO for third molars. She was wearing those large hoop earrings that were popular then. I told her all jewelry had to come off. I left to get a cassette.

When I came back, I realized there had been a miscommunication—she had neatly placed all her clothes in a pile next to her. If I were cool, I would have simply put the cassette in the machine, pressed the switch, and said, “You can get dressed now.” Instead, she could tell from my expression that a big mistake had occurred.

I left her to get dressed, hoping that Susman wouldn’t come back and I wouldn’t have to explain this. She got dressed, I took the image, we both apologized—and I didn’t have to visit Susman or the Dean.

Family

Life’s Biggest Lessons

Being told you have a 10% chance of living 36 months is very liberating. When I went in for my radical neck surgery, I had contacted a practice broker. He advised me that my practice would never again be as valuable as it was at that time. I was to sign the papers after the operation.

During the initial recovery, some dentist friends suggested I keep the practice so I wouldn’t just sit at home and watch the clock tick down. The result: I withdrew the contract, drastically scaled back my procedures, and muddled along.

My wisest decision was reducing everything that caused stress in my life. I fired all the annoying patients and insurance companies. I did it nicely—I told them I was dying and they needed to find a new DDS.

Thirty-two months later, the cancer was back—Stage 3.

I’m alive because of the brilliant doctors at the Cleveland Clinic who accepted me into a Phase I clinical trial of Adoptive Immunotherapy. Five and a half years later, they ordered CT, MRI, and PET scans. The PET scan operator thought he had the wrong medical record. He told me I was cured and that I should go home and take my wife out to dinner. Which I did.

That I was cured was as big a shock as the terminal diagnosis had been.

Damn, now I had to be responsible.

However, I’d grown used to my low-stress practice and decided to maintain an out-of-network business model focusing on what I enjoyed in dentistry. That model has served me well.

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