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I only remember my friends as having little teeth as so I can’t comment on their current state or the orthodontia sagas they may have endured. I should add here that I was also a thumb-sucker.


My orthognathic surgeon was all the way up in The Bronx. Up in the Bainbridge section off the 4 train, near the houses that like looked upgrades of the Smurf village – narrow, upright brown and burgundy red brick structures with pointed roofs shaped like upside down Vs and shrubs closely enveloping the exterior with entrances providing secrecy, privacy and urban nobility.

The surgeon himself was part of Montefiore Hospital. In his office, they made a mold of my mouth by sticking human tolerable cement – imagine Wrigley’s Spearmint Gum in a wad but without the sugar, and tougher and thicker – in my mouth twice for upper and lower castings. My jaw was misaligned, presumably congenital, though I do remember a time when I could bite my nails using my back teeth. My theory about the misalignment was that it had come from my father holding his hand over my mouth at night to keep me quiet. There’s no way to verify this and I don’t expect to get an honest answer from my perpetrator.

It was a long time in that chair often unattended. I stared at the peach colored walls, and felt at times as if I’d been abandoned or deemed a case that was just too difficult, requiring carefully chosen speech – the short version of which was,  “Sorry, kiddo, you’re fucked for life”. I told the surgeon that I was an incest survivor and my theory about the malocclusion. He took it in. I assumed he thought I was over-educated and slightly off but if he felt that way, it didn’t show in his continued work.

The cost for the surgery itself was prohibitive because dental insurance only covers so much. After the surgery, I would also need braces. Dental insurance providers have not made allowances for adults who were wronged as children who want to right themselves. I’d spent time with a list of questions haggling with them over the phone, and then pushed and pulled all I could from my health insurance provider as well in an effort to cover the cost. Either way, some money would eventually have to come out my own pocket. I hadn’t been able to save for it, and planned to pray to marry a rich and emotionally mature man.   I wanted to fix the crooked smile that I had and look better that I did. The fact that it had not occurred to me to formulate a plan to address the imperfection indicated there was an issue with my level of self-awareness. People often cared how they looked, presented, appeared.  I did not deeply but often wondered if I should. To appear to have the same insecurities as everyone else might make me feel less like an outlier. My insecurities often felt inconsolable and soul seared to me until I died: What would happen to me if my mother died before my father, and it was just he and I?  Even though I was an adult, the fear was still there of being unprotected and violated again.


I was born in London in the 70’s. The American cult of perfectly white teeth was not as prevalent as it is today. I don’t think my parents purposely decided that they weren’t going to pay for my orthodontia though I was later told in adulthood by my father in an off the cuff remark that there was no money to pay for it. My parents had always worked and had insurance through their respective jobs so it has always seemed odd to me that there was money for a car, a co-op, and my private school education plus my mother’s bachelor’s and master’s but no money to cover my dentistry surgery. They don’t seem to mind my crooked mouth but I wanted to right the wrong.

The British have long been the punch line for bad oral care. It’s not clear where this came from but perhaps it has something to do with all the tea we drink and the high amount of sweet cakes and cookies we consume.  Because I came to the United States when I was 7, I only remember my friends as having little teeth as so I can’t comment on their current state or the orthodontia sagas they may have endured. I should add here that I was also a thumb-sucker. Those familiar with this will know that the habit can push the teeth forward as they are evolving and growing. Somewhere between ages 4 – 6, my father bound each of my hands at night before I went to sleep so I wouldn’t suck my thumb or scratch due to eczema. Immediately after he left, I would be upright under the covers in the dark, desperately trying to pull them off but I couldn’t. I would eventually fall asleep defeated and trapped.


Dr. Suslova, my dentist who had suggested I see the orthognathic surgeon, was the recommendation of someone I’d met in a support group. Her first office lay on the outskirts of NYU and was close to Washington Square Park. She is Eastern European, and wears glasses that don’t have frames, just golden arms burrowed into the lenses. She is lovely and smart about her treatment. It’s not clear how she feels when she looks at my crooked mouth. If she feels horror or revulsion, she never lets on.

That office was large and long, with blue walls, dark brown office furniture and low ceilings. The waiting room, to the left of the entrance, had magazines on a low table and dark wall colorings. The receptionist, a middle–aged black woman, was matter of fact. On an appointment day where I’d been having a rough time prior to my arrival, had possibly been crying and arrived late, she barked as soon as I’d walked in, ‘You’re late.’ She was the human manifestation of the squawk box in my head that relentlessly informed me of my shame, insecurity and mistakes.  Yes, I had trouble getting to places on time.  Why this was was a mystery. I wanted to be black or I wanted to be late but to be reminded that I was late while black reminded me that I was representing the race everywhere I went and that I shouldn’t be another disappointment who was embarrassing us by showing up on colored peoples’ time.  I didn’t need the additional pressure that the burden placed on me and resented her calling me out in front of other patients who were frequently white.  

The office had at least 1 – 2 other dentists in there, and the group shared dental hygienists. At times, Dr, Suslova, performed both my dental exam and cleaning herself. She was, and continues to be, very tender and softly probing when moving in my mouth. When she or the instruments pull against my cheek, she does not stretch it until it hurts and will create a memory of a pain. She is aware of the limitations of a human mouth – and my mouth as its own – and always pushes just enough to see what she needs to, conscientiously. When she does this, I always feel as if she remembers what it was like to be a dental student – lying prostrate on a high chair, arms folded in her lap, vulnerable, communication thwarted and waiting for a face to swoop in to needle at your largest bodily opening so you can better chew and show the world you’re happy to be here.


My therapy efforts started in earnest when I graduated from college. Before that, I’d had one attempt while in high school after I skipped high school for the only time in my life. The reason for skipping school was due to depression and suicidal ideation for reasons that were unclear to me at the time. Home and school life appeared to be as it should. I was busy with school work and hanging out with friends. There were no boyfriends but I managed to snag a date for the prom that we – a small all-girls graduating class of 33 – ultimately elected not to have.

On the day I skipped school, I rode the 5 train to 86th Street as I had been doing for the past 6 years. Dread did not describe what I was feeling. It was more an acute forlornness with a profound sense of wrongness.  I was not right, could not do right, and wanted to kill myself due to a lack of a solution. The feelings were a climax of what I’d been feeling since 8th grade. During that year, I’d struggled to pay attention in history class while my history teacher droned on about the ancien regime. I struggled to read my history homework in the fat yellow book that served as our text, reading paragraphs over and over again, each reading vanishing into a black hole of inattention and thought wandering. Most of the pages were highlighted indicating that everything and nothing was important.

At 125th street, a black woman got into my car. She seemed unbalanced, hesitant and did not rush to the available seats like most commuters would. Her clothing was dark and draped, layered. She walked up and down the car and then stopped in front of me, bending slightly to look straight into my eyes where I was sitting.

“Is your name Tia?”

I swallowed. I couldn’t even skip school this one time without a child of God being sent by the Heavenly Father himself to inform me that my dereliction of duty had been noticed in real time.  


“Do you remember me?”  

I considered the question seriously.  I had never seen this woman before in my life.

“Is your name Tia?” she asked again.  Again, I answered yes. Satisfied, she walked away from me and muttered out loud to no one in particular that she knew it was me. Panicked, I was sure she’d get of at my stop in order to deliver God’s message.  By using one of his seemingly lost souls as his instrument, He would tell me that he forgave and loved me and that my pain would pass – this according to my uninformed understanding of how spiritual experiences worked.  

The train continued through the darkness. The woman stayed on my left, walking back and forth in the unobstructed space in front of the door. Other passengers glanced at her, quickly assessed her kind of crazy, and felt safe enough with their evaluation to ignore her.  

As the train pulled into the 86th Street station,  I slowly gathered myself together – strapping my backpack on and sitting with it while teetering on the edge of the seat. Ordinarily, I would have jumped up as the train was approaching and poised myself in front of the door so I could be one of the first ones off. In this instance, I let the train came to a full stop so I could make sure the mystery woman got off first, which she did. I became a tourist, deliberate in setting my foot on the platform and slow to take my space on it in a definitive direction. I was looking for her, needed to know where she’d gone, but she had disappeared. The rest of the express train crowd thinned out onto the streets.  Two – three minutes passed – eons in morning commute land – before I walked up the stairs and out of the station.  The woman was still nowhere to be found. God’s message had ultimately been unclear and haunting.  

It was at that point that I definitively decided I would be unable to attend school that day. I knew I wouldn’t be able to handle it due to being consumed with sadness and now confusion as I felt God had sent a messenger to help me but she had unable to get past confirming she’d found the right recipient.  The only other place I knew to go was home but that was not an option. I was now in between worlds that I knew well but I had no plan. I wanted to tell someone that I trusted how I was feeling but the likely suspects – school administrators – were certainly out. Too visible and too intimate. I was in my sixth and final year at a private school. Academic fortitude had brought me there on scholarship and that could not be interrupted. A breakdown was for the white woman who unexpectedly did not return after summer vacation or abruptly transferred to a boarding or less rigorous private school at the end of a trimester.  She had the luxury of falling apart with adequate support and resources and understanding. This was not an option for a working class person of color for the usual underlying message that existed in the black community: We are not allowed to fall apart, appear vulnerable, request a break or fail when life changing opportunities are presented. Besides, any mental defect discovered in me would involve my parents, who would not handle this well. We would have to address how I was feeling and for how long and the conversations would be uncomfortable because we never talked as if I had feelings, wants, longings, difficulties, darkness. I needed to find someone who could counter that, for whom feeling exploration was comfortable and well practiced.

I went to see a counselor from Prep for Prep that I knew.  Prep for Prep is a ‘leadership development program’ that offers intellectually gifted public school students of color the chance to receive a private school education. The program is rigorous, and has a 3 step screening process before admittance.  Once accepted, students attend classes during the school year on Wednesday evening, all day Saturdays, and during 2 consecutive summers. I had entered the program as a 5th grader, and by the time I was finished in the summer after 6th grade, I had been accepted into my private all-girls school as an incoming 7th grader. I had started doing volunteer work for them in  9th or 10th grade, and knew the staff fairly well.  Their headquarters were on the Upper West Side.

I took the 86th Street crosstown bus and walked a few blocks to the building, commonly referred to by all Prep staff and students as The Brownstone. It was after 9 am. Ms. Johnson was located on the second floor. As someone known to staff, I could see her without having to explain why. When I found out she wasn’t there, I felt hot and exposed, as if I’d been called a fraud.  I didn’t have a backup plan and no tools to process what I was feeling other than to spill it all someone, take comfort in the release, and rely on the adult to have the answer. My feelings were consuming, repetitive and self-destructive.

Though I wanted to draw the least amount of attention to myself, I allowed myself to ask one question:  When would she be in? Later in the day, I was told. I made sure to say thank you so as to indicate I didn’t need any more help and could be left alone.  The few staff that had gathered curiously around me in a loose semi-circle dispersed. The student required no concern.

I wrote Ms. Johnson a note in which I told her that I didn’t know what to do, that I was suicidal, and that I needed help. I taped it securely to the bottom left corner of her desk with her name written on the front. The likelihood that someone could surreptitiously read what I’d written and re-tape it to her desk was zero. Ms. Johnson – who had taken every word I’d ever spoken to her seriously, who cocked her head earnestly to the side when she listened, who always paused before she responded, who had full soft light brown cheeks, who wore shiny dark red lipstick on her small mouth, who was warm and elegant – she would know what to do.  

The narrow and tight floor plan on each of the five floors of The Brownstone left you feeling hemmed in, and required you be deft and acute about knowing where you were going and whom you were there to see.  It was a mouse maze of desks, cabinets and piles at 90-degree angles that befitted a program that nurtured and supported academic achievement. There was little room for my loss of emotional cohesion and no reason for me stay since my rescuer was not available.  I fled the building.

Had I called the school nurse, and told her that I was too ill to come to school, my plan to cut school undetected would have succeeded though what I might have done to myself, given the depth of my despair, is unknown. I don’t remember how I spent the rest of my day but I did eventually go home.  I remember being in a fearful daze and vaguely remember the phone being passed between my parents and I so we could each speak to Ms. Johnson, who called when we had all arrived home.   After the call,  my parents behaviour towards me felt kinder, softer, tender – emotions I rarely experienced from them.  Despite the interim gentleness, I was most concerned about how my father would react because he didn’t like to be inconvenienced, and the fact that I was not feeling well, to put it mildly, was an inconvenience. Based on past experiences, inconveniences led to anger.  Once, a girl from school who lived up the block came to our house for a drink.  It was summer and she was left alone during the days in her apartment with her younger sister.   I gave them a glass of juice to share and went to my bedroom for a few minutes before I heard arguing and the shatter of glass.  The girls had been arguing over the drink and it had fallen as a result.  My father had had his head to the side on a pillow comfortably watching tv on the small black and white set in his room.  When he came to the kitchen due to the glass breaking, my heart rate increased and I got hot, afraid I’d be in trouble.  He had kissed his teeth and demanded to know what happened. The girls instantly blamed each other.  I wanted them to cut it out and stop looking weak in front of this man.  We needed to be strong so I wouldn’t feel so afraid.  The girls were made to leave, and I knew they’d never be coming to our house again due to this mistake.  My father was disgusted, and swept up the glass with the dustpan.  The ensuing silence felt threatening.  Though the accident was not my fault and I was not yelled at as I thought I would be, I sensed vehement blame for the type of people I’d brought into our home – people who couldn’t act right and behave.  He returned to the bedroom, and I remained bumbling around the fridge, unfreezing and waiting for the dissociation to run its course.  My father’s anger terrified  me. It was confusing; it discriminated against nothing including things I’d thought would be understood because I was a young person – mistakes, missteps, clumsiness, lost moorings. I was sure he was secretly disgusted now due to my showcasing a weakness that inconvenienced him once again.  I needed support, love and understanding, and, additionally, had told a stranger I needed this as well.  My mouth had exposed the family as being less than the perfect.  As a result, the long term outcome of this confession was presumably not going to be to my advantage.

During the phone conversation, Ms. Johnson, my parents and I agreed that I would receive therapy at City College, located on West 137th Street. My father would pick me up from there after the session one day a week. It was a secret place to go to after school that didn’t fit in with other senior year extra-curricular activities which were fun, and encouraged autonomy and achievement. Therapy felt odd, like I’d failed a test that I couldn’t talk about taking.  It was serious and meant something was wrong.  Suddenly life seemed heavy, and I started viewing the cars going by outside the low windows in my homeroom as missed opportunities for escape. The visits would cue an introspection that was deeper than our yearly high school self-esteem building exercises and was different from the profundity of being a working class person of color at a predominantly white private all girls school as a scholarship student.  That subject matter could be discussed jointly with my other friends of color, parsed and lamented and then tucked away when the matter got too heavy or when we needed to go to our next class or go home. It did not involve possibly looking at family, talking about family, analysis of self and family.

On a day after school, I trekked to City College alone. The building I entered was a light metallic grey, tall and long.  I thought of sardine cans with smoother corners stacked to form upside down pyramids. There was no way to discern what went on inside the building even though I knew it was a college. The windows were tinted black, the people inside hard to see.  The hallways were long, and contained doors to rooms that appeared as if they would keep me forever.  There was no information desk on the floors, and no notice that I was lost and unsure. Finally, I asked someone for directions to the correct floor and room.

When I arrived at the room, the door was tall and open, and Kerri was inside waiting for me.  Kerri was a young white woman about 5’6″ with shoulder length dirty blond hair that was uncombed and unstyled. Her face was oblong shaped, slightly pockmarked and unassuming. I was coming from school so I was wearing my uniform – a plaid kilt or a solid green skirt as per our uniform options. I may have had on an expensive jacket  – Armani, Agnis b – that I got from my aunt who worked for wealthy individuals who frequently gifted her with pricey castoffs – or perhaps a GAP sweater in a uniform matching color or a black tuxedo jacket that had belonged to my grandfather that I loved because it fit me well. It was worn whenever I wanted to look good for the day – perhaps while giving a tour or going to another school for a Badminton match or attending an away game as the manager of the basketball or volleyball team at a co-ed school. My hair might have been back in one, permed and wrapped with a plain black scarf, and I might have been wearing some clip on earrings – gold plated drops or rhinestone flowers, both courtesy again of my aunt’s employer largesse. I rimmed my eyes – top lid only – with waterproof brown black eyeliner which complemented the clear mascara I wore.  I would not be caught dead without my contacts. Physical appearance was important to me in high school. When done right, it can illuminate, obfuscate or shield. In high school, I wanted to illuminate, as my self-esteem had not yet fallen completely to the wayside, and I still cared about looking good.  

I had asked for help and here it was.  However, help quickly became uninteresting, a drag and something I dreaded. My sessions with Kerri are hazy.  I was numb and probably disconnected, and didn’t really understand how the process of memory, exploration, connection and revealing really worked.  We were opening up places I’d hadn’t thought about ever, detangling rope to create a clean space that would be inhabited by my pov only. The long and narrow room did not support this exploration, and as such, may have contributed to its failure. The minimal furniture  – consisting of my chair and her chair only – was mismatched and suggested anything goes. The walls were bare, white, dirty and yielded nothing. She was young and I was younger.  We hadn’t lived long enough, even collectively, to make it work. There were no tricks we could use to jump start a movement of sharing.

Meanwhile, my life outside of therapy was going on as usual.  My breakdown felt like a blip. I had returned to school the next day after I’d been absent, continued to sleep late on the weekends as I always did and was also applying to college as I was supposed to. My parents continued to work during the week, buy takeout on Fridays, and do laundry and grocery shopping on the weekends while I stayed home like I always did. Where was the chasm that needed to be explored and closed?

I soon became a terrible and inconsiderate patient who missed sessions without informing her that I wouldn’t be there, and let the guilt sit under my skin while I did something else or nothing else at all but simply not be there.  Kerri called my parents and I returned. She looked at me, hair still uncombed, head cocked to the side. She was clearly pissed at me for wasting her time but spoke to me professionally when telling me so. It was our last session. I was free from the burden of help.

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