Welcome to The Teen Behavioral Network

teen titans
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How strange that the young should always think the world is against them – when in fact that is the only time it is for them.  ~Mignon McLaughlin, The Neurotic’s Notebook, 1960

Tired of late night cell phone debates with your teens over dubious sleep-over locations and questionable acquaintances?  Worried what kind of den she is calling from ? Unsure whether those red eyes are really from studying or fighting forest fires?  Does your teen make OJ Simpson look truthful? Consider joining The Teen Behavioral Network (TBN)

At TBN, our mission has remained the same, helping teens avoid self sabotage.  During your child’s transformation from adolescence into adulthood, they are statistically at greater risk from a host of acute physical and mental illnesses ranging from situational retardation syndrome (SRS), serial mood swings (SMS), poor peripheral vision (PPV) and episodic events such as auto accidents, broken bones and ruptured relationships.

We want to take this opportunity to socialize you to the benefits, provisions and clinical protocols of our program.  TBN is an incentive based care coordination program underpinned by an exclusive network of friends, acquaintances and families.  Under a typical TBN program, your teen’s activities will require them to call an 800 number to obtain preauthorization for certain risk based activities. Our goal is to help direct them toward people, places and activities that are most likely to reduce their risk for catastrophic events which could sidetrack their progress in life.

Based on decades of evidence and outcomes based data, we have designed a comprehensive physical and mental health program that incorporates the following:

1)      Biometric, academic and psychometric baseline testing – At TBN, we believe you cannot improve what you cannot measure. Periodically, your teen will submit to a basic biometric testing administered by a primary care physician.  We will test key biometric markers such as fasting glucose (blood sugar), weight, blood alcohol and banned substances to baseline overall health status.  We triangulate this data with your child’s grade point average and a two-hour annual psychotherapy session to determine an overall risk score. The lower a teen’s risk score, the less likely they are to commit a monumentally stupid act which could irreversibly impact their future.  Our goal is to reward good behavior and to limit at risk activities to within our preferred partner network.

Based on each child’s risk score, we develop a customized plan to assist them in moving toward “first quartile” social stewardship and personal responsibility.  Our assessment may uncover abnormally high glucose and insulin levels from consumption of sodas, fatty foods and empty carbohydrate diets.  The absence of lactic acid in your teen’s muscles may suggest they are leading too sedentary a lifestyle. 

Our initial baseline risk assessment will graph your member teen’s risk status against local, regional and national peer risk groups to drive toward improvement.  As he/she achieves milestone events, our incentive plan rewards them with behavior points which can be converted into a range of valued rewards such cell phone minutes, PC and phone upgrades, sleep-overs at approved in-network homes and iTunes purchases. Failure to achieve agreed targeted benchmarks results in a series of compulsory physical and behavioral remediation programs offered through affiliated local law enforcement and armed services partnerships

2)      Preferred Partner Organization (PPO) – Every teen member will be provided a customized approved network designating “in-network” friends, family and institutions.  Members may participate in a range of activities in network with no out of pocket expense or preauthorization. 

TBN has gone to great lengths to develop a process for screening and stratifying in-network friends, families and institutions. We pride ourselves on the little things. Our “family” reviewers perform on site inspections and are sensitized to the most subtle signs of laissez-faire oversight such as the absence of alcohol or medicine cabinet inventory controls or content blocking on cable and computers.

While our criteria is kept extremely confidential, each network is unique based upon your teen’s risk profile and the risk factors attributable to other teen members. Certain low risk places or people such as a local church youth group, YMCA or deli are likely to be shared across multiple teen networks.  Certain “in network” friends may receive additional performance stars for characteristics such as intellect judgment, civic responsibility, home supervision and number of text messages sent in a 24 hour period. Five star friends are considered “centers of excellence” (COEs).  COEs are eligible for subsidized activities such as inclusion on family vacations, movies, deli and coffee coupons.

Given the extreme variability of teenagers, our PPO network guide is updated hourly

3)      Out-of Network PPO Access – A teen attempting to access out-of-network friends or institutions must submit an out of network request at least 24 hours prior to the planned event.  Our 24 hour authorization line is staffed with retired teachers, clergy, grandparents, animal trainers and clinical psychologists expert in dealing with pathological behavior.

 You will be provided five micro-chip GPS patches that can be surreptitiously  inserted in your teenagers phone, purse and/or high top sneakers.  The “soft perimeter” tracking device allows you to instantly access your teen’s location via any personal computer or cell phone.  

 Unauthorized Out of network PPO activity may include penalties such as chore deductibles and/or community service co-pays. Each teen must submit location information that includes a JPEG photograph transmitted via cell phone for verification. 

We have retained several per diem private investigators to assist the out of network approval review process.  For a few extra dollars a month you can receive full individual and family background checks and a risk dossier outlining of all public domain information of every person and institution with whom your child may be attempting to affiliate..

4)      Appeals – Teens desiring to appeal out of network denials can request a supervisory appeal from our verification team. Our appeals teams are composed of recovering alcoholics, parole officers and social workers – – all bi-lingual in text messaging and English.  We have recently contracted with Apple to introduce “ iTruth”, a polygraph based wireless application for the iPhone where teens can  attach sensor pads from their phone USB port to their temples. Through an ASP server, users can be evaluated to determine if they are telling the truth. Future programs include iBlow, a breathalyzer app and iBrain, a dopamine and serotonin measurement device.

5)      Final Appeals – Some determined teens may refuse to accept appeals as a basis for final resolution. In these cases, we have designated a “final appeals” protocol. A teen may invoke two final appeal challenges within a one year coverage period – similar to professional football’s red flag challenge.  We employ retired juvenile court judges on 24/7 retainers to arbitrate specific appeals.  Appeal overturn rates for 2010 were less than .005%.  Problematic or disrespectful members will be automatically redirected to a payphone at Bellevue Hospital for the Criminally Insane where teens can attempt to reason with equally irrational people.  These calls are recorded and forwarded to the member parent for entertainment value.

At TBN, our program is simple – – we seek to improve the health and well-being of your teen and to assist them as they navigate a period where they are physiologically and socially incapable of distinguishing risk and consequences.  Youth participants are socialized to understand that in a small town, one’s reputation is easy to lose and hard to recover.

Our motto: “Trust But Verify” reflects our mission to establish guard rails characterized by mutual respect, honesty and consequences for behavior.  We will leave no teen behind and our goal is to ensure that any misstep is minor ……………….(no pun intended).

Walk It Off

broken ankle
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“Pain is weakness leaving the body” – Tom Sobal

In 1000 AD England, King Elthred was supreme ruler on earth. To villagers and peasants, life was a fragile gossamer strand that could be snapped by a sudden invisible hand as easily as one might brush aside a spider’s web.

Healers relied on sacred and profane remedies to exorcise the physical demons that brought plagues and misery. In darker times, giving in meant giving up. People learned early to chide and cajole the injured and infirmed ( gettest thou out of bed, you are fine !) as if to acknowledge the severity of their condition would make it a self fulfilling prophesy.

In the late 1500’s, an unusual illustrated journal maintained by an 11th century monk revealed much about life and death in the dark ages. In one protracted pictograph of medieval medicine, leaches were applied to the legs of individuals with circulatory and psychological ailments.  With their parasitic poultice in tow, the afflicted were expected to walk great distances – presumably to increase circulation – which in turn would swell the growth of the leach until it would literally burst off the patient’s skin.  This bloody explosion was said to mark the point at which the bad blood had been extracted, improving the odds for a speedy recovery.  It was theorized by one etymologist that this was the genesis of the Anglican stiff upper lip expression – “walk it off.”

Centuries later, I recall being beaned in the right leg during a high school scrimmage by Jim Gott, an all-county pitcher who threw laser fastballs in excess of 90 mph.  Gott went on to enjoy a decade long career in Major League Baseball with stints as a reliever for the Blue Jays, Giants and Dodgers. On this day, he all but fractured my femur with a low and tight slider that chose not to break.  I am reminded of the blinding flash of pain as well as the taste of red dirt on my tongue as I writhed in the chalk of the batters box. I distinctly recollect the unsympathetic cacophony of fathers and coaches who all yelled out precisely at the same moment, “walk it off, Turpin!”

As I got up limping on one leg, I shot an indignant leer through the chain-linked backstop. I saw distain on their ancient faces and could almost divine their prehistoric thoughts.  “that kid, what a milk toast. “ and “It’s just as well his father isn’t hear to see this.”

Injuries were common in the era of free-range kids. There were road rash bicycle accidents, sandlot football broken arms, Fourth of July firework burns, and new scout knife gashes. We knew emergency room nurses on a first name basis. Yet these ladies only saw a fraction of our maladies as with most families of our generation, we used the “O Squared” method to triage medical events.  The O squared rule simply stated that one must have been bleeding from at least two orifices to merit professional medical attention. This therapeutic best practice was not unique to our family.  It was an indispensable axiom for our entire neighborhood including the Del Santo family, a classically prolific, eleven-kid Italian Catholic family that lived directly diagonal to our back yard.

The Dels kitchen was a 24-hour MASH hospital. I can distinctly recall one of the Del Santo boys breaking his finger and attempting to get treatment from Mrs. Del, a saint of a mother who, while holding a screaming child, cooking bacon and eggs and dragging two other toddlers attached to her ankles, adroitly administered a field dressing with the detached calm of a battlefield corpsman.

In a treatment torn from the page of a survivalist field manual, Mrs. Del grabbed a long plastic Lego, scotch tape and set the finger.  Both patient and parent seemed content with the makeshift splint although, I was personally stunned that the stopgap remedy became permanent and was never replaced with the popular metal splint encased in white gauze and athletic tape.

In the days of  “man up” medicine, athletic coaches did not get sued for pushing athletes to the point of heat exhaustion or vomiting. Having survived the Army with a crusty Master Sergeant who was the only survivor of a platoon overrun in North Korea, my father considered pain an essential process in forging stronger character.  Through suffering, one could achieve a higher plane of consciousness where pain ultimately subsided.  (We now know this higher plateau to be known as shock.) However, in the days of ” tough it out” and shake it off”, no one iced a monkey bump the size of a golf ball, paid attention to the bruise on your left quad that resembled the continent of Australia or woke you up every hour after taking a shot to the head in football.

It was not uncommon to come into the house balling uncontrollably after you had just pounded a nail through your hand while building a primitive fort or plunged an ice pick into your thigh while removing grout from shower. Parents of the 60s would actually hit you to calm you – perhaps influenced by war movies where the tough officer slaps the hysterically wounded man. ” Get a hold of yourself, Bob. You still have your other leg.” Once slapped out of your self-pity, your parent would proceed to pour stinging rubbing alcohol on your gaping wound causing you to shriek and leap uncontrollably out of your chair.  Another therapeutic slap reduced you to a drooling, blubbering, shaking mass of blood stained clothes.

In days before the over prescription of antibiotics created superbugs and killer staph infections, a boil would not be considered life threatening but instead be lanced with a sterilized sewing needle and protected with a simple 3 inch Band-Aid.  A summer splinter was dug out with that same needle as you were screaming, “ no, I can walk with this in my foot, no!”

One would think with this tough love education that we would have grown into a society of practical homeopaths eschewing formal medicine for crazy glue, anti-bacterial ointment and a rubber belt to bite on. As we became parents, we changed from Darwinian fatalists into empathetic hyperactive helicopter parents.  Actually, the opposite occurred.  At every sniffle, sneeze or throaty cough, we rushed our first-borns to emergency clinics and to pediatricians begging for antibiotics because we could not stand the uncertainty of an illness.  We wanted instant resolution and it contributed to creating a healthcare system that was all too eager to accommodate our anxieties.

As we got older and realized our children were more or less indestructible objects, we became part of the cavalcade of “ walk it off “ parents.  After our son fell while swinging on his pull up bar, we chastised him and sent him to bed – despite his complaints that his hand was hurting.  Two days later, he was diagnosed with a broken bone in his hand (ok, so maybe it was four days later).  Our daughter took a bad spill while playing soccer – again there was whining about a sore shoulder and neck.  “ You’re fine,” we told her as she complained about being too sore to practice.  Three days later we were looking at the X-Ray that revealed the broken collarbone. Oops!

It is a cool autumn football night as I wander over to midweek practice fields that buzz under an eerie glow reminiscent of alien landing lights.  There is a symphony of yells, whistles, smacking helmets and tribal clapping followed by a singular outburst  “break!”

A padded adolescent warrior lies on the ground and is slow getting up.  As players take a knee in a sign of solidarity, a coach sympathetically touches the players shoulder pad and coaxes him to sit up. Across the turf field, a father paces uneasily. His large build and slight limp suggest a lifetime of contact athletics.  I am secretly critical as he is obviously barely restraining his need to run on to the field to hold his son. He moves closer to the sideline straining to see his player, attempting to ascertain the nature of his injury.  As a veteran “ tough it out” parent, I start towards him to reassure him that his progeny will be fine.  He can hold it in no longer. Cupping his hands to his mouth, he screams,  “Come on Jimmy, you’re fine.  Get back in there!”

I feel a sudden chill and for a moment, sense my father is right behind me, seated on wooden bleachers urging me to suck it up and get back in the game.  I turn, expecting to see him restlessly pacing, waiting for me to dust myself off and hustle down to first base.

There is no one there.  As I turn to return to my observation post, I stumble over an equipment bag tossed on the sidelines and hit my knee on the gurf field.  Dusting myself off and limping over to the fence, I glance up hoping no one has witnessed my gaffe.  In the shadows lurks another late 40’s father.  He is obviously an alumnus of the “suck it up academy”.

“Walk it off, dude” he says with a chuckle.

The Bulge

The Bulge

Life expectancy would grow by leaps and bounds if green vegetables smelled as good as bacon.  ~Doug Larson

About two years ago, I experienced a series of humiliating encounters that forced me to come to grips with my expanding waistline and my highly evolved denial of middle age.  I chronicled my battle of the bulge in an early 2007 column figuring that if I publically declared myself on a diet, it would be harder to enter a Dunkin Donuts without someone ratting me out to my spouse.  The first dose of reality came in the form of attempting to squeeze into one of my “thin guy “ suits that I kept in my closet in hopes that a case of giardia or lock jaw might shrink me back to the days of a 34 inch waist.  The futile effort to be thin backfired when later that day the waist button shot off my pants and almost put out someone’s eye.  Instead of accepting my need to diet, I chose to blame my tailor for shoddy alteration work.  A week later on a business trip, I split the seat of my pants to create a hole bigger than the Lincoln Tunnel.  The loss of dignity trying to buy a new pair of pants in Buckhead, Atlanta at 8am while my BVDs were smiling at everyone was priceless.  The final rock shattering my glass house of denial involved breaking several pieces of furniture including a chaissez lounge and a toilet seat. I promptly tried to blame the broken seat on the kids, then on the cat and finally the manufacturer.  If Church had actually followed through on their promise of offering “The Best Seat in the House”, I’d probably still be feasting on cookie dough, ignoring my spouse’s and doctor’s strong suggestions for exercise and diet.

I was leading a double life.  As a healthcare executive, I was busy chiding America for its lack of personal responsibility around health.  The fact is that America is fat and I had become one of those middle aged round mounds of  rebound.  I was the average Joe with a waist size that had grown in just two decades from an average of 34 inches in 1988 to a squishy 38 inches in 2008.  My theory was you never knew when the next great famine was going to hit and I had to be ready.  60 million other Americans agreed with me and were an average of 30 lbs overweight.  The sad truth was that each pound increased the likelihood that I might fall prey to any number of infinitely preventable chronic illnesses.  Obesity drives a host of little nasties such as diabetes, various forms of cancer and cardiovascular disease – -sometimes one hits the trifecta and develops all three.  By day, I expounded the virtues of exercise, diet and moderation.  By night, I was marching through our pantry like Sherman through Georgia, eliciting alarming cries from the local citizenry such as “Mom, who ate the Oreos?” or “ I did not even get a Pop Tart!”. My spouse had long since suspected my nocturnal activities.  I was not sure if there was a hidden camera but I do recall one night coming home late from a business trip and to my delight, I spied some brownies covered in foil on the counter.  As I descended on them, I noticed a note attached to the foil that read, “Don’t even think about it.”

I then had my moment of clarity. It started like any other morning with no breakfast and several cups of coffee.  It proved to be a stressful day of contiguous meetings, no lunch and a race through Friday night traffic to get to my son’s travel basketball game in Danbury by 7PM. I was stuck on a conference call while driving through an unfamiliar industrial park looking for a gymnasium the size of a card board box.  Suddenly, my heart started doing the conga and I pulled over to the side of road.  I sat there waiting for the drum solo to pass and suddenly felt like Red Foxx in Sanford & Son.  “It’s the big one Elizabeth!  I’m coming!”  The fact I had not eaten anything in twelve hours and was more jacked up on Columbian Marching Water than Will Ferrell in “Kicking and Screaming”, was lost on me.  For the next few days, my heart would occasionally launch into a break dance.  I would quietly administer myself last rites and confide in my spouse who assumed it was yet another of my numerous psychosomatic episodes.  I turned myself into my GP, the wise Dr P, who gave me the same look as my wife did.  My lab results revealed HDL, LDL, and Triglycerides of a person who works in a bakery sampling cheese danish.  My Oreo party was over.

It was at this precise moment that I was also introduced to Dr. Mehmet Oz, a noted author, cardiovascular surgeon and talk show personality.  Dr. Oz and I were sharing the speaking duties at a conference on issues plaguing the US healthcare system.  As I listened to Dr Oz discuss his latest book, You: Staying Young: The Owner’s Manual for Extending Your Warranty, I carefully recorded what I must do to achieve a prolonged higher quality of life.  Oz helped me focus on those highest impact areas that might determine whether my golden years were a high water mark of vitality or a tidal wave overwhelming me with frailty and chronic illness.

Oz makes it clear, that your body, like an automobile, can travel several hundred thousand miles with some committed maintenance.  His advice includes:

1)    Waist Not, Want Not – the waist line is the number one area to manage – Forget the preoccupation with the buns and legs.  The omentum is one of the main storage depots for fat in the body.  It sits within the belly and stores fat within the waist and inner stomach.  Excessive omentary fat is what we see in beer bellies and tummy “pooches”.  It is more damaging than any other fat source on one’s body.  It interferes with insulin production and wreaks havoc on our internal organs.  Keeping your waist measurements at least one half of your height will give you a fighting chance to hit your eighties and still be able to tango.

2)    An Ounce of Prevention – for men and women, we avoid these annual tests rationalizing that no symptoms, mean all is well.  Early detection is essential to catching and beating many diseases.  Delaying that pap smear, mammography, PSA test, colorectal or endoscopy only increases your risk.

3)    Out with Meat, In with Fish – Fish is rich in Omega 3 fatty acids and low in saturated fats.  Saturated fats cause inflammation and cholesterol problems. Omega 3’s are credited with joint lubrication, reduced blood clotting, ameliorated menopausal symptoms, and improved memory.  The down side of popping those fish oil pills is smelling as if you are having an affair with a rock cod.

4)    Go For Color – Eat red, blue and yellow fruits and veggies.  Consider the healing effects of blueberries, tomatoes, peppers and yellow squash. These foods are rich in antioxidants and fight free radicals that damage cells and encourage you to vote for a single payer health care system.

5)    Fight The White – Start reducing sugar and white flour products.  This one is hard to police but it is essential to reducing the diseases which plague countries that consume large amounts of processed foods.  Whole grains and fiber will make you help you age gracefully and ensure you know the location of every public restroom in Fairfield County.

6)  Look at the Dog – A wise person once said, “If your dog is fat, you’re not getting enough exercise.” You need to maintain muscles, bone density and proper body chemistry that can only come with moving the old body.

Remember, it’s all for you so you can live a life as rich on the back end as it has been on the front.  You can even join me in 2050 as we take a group out for a little tango.  However, if I show up claiming to be Fred Astaire and dancing with a mannequin, just humor me…..

Odontophobe

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“ I told my dentist I had yellow teeth.  He told me to buy a brown tie”  – R.Dangerfield

I have certain nightmares that reoccur with bizarre frequency.  Stress, tight deadlines or being asked to clean out the kitty litter box can trigger the same dream where I awaken back in college, minutes before all my final exams and I have not attended a class all semester. To my father’s chagrin, this dream is not too far from what actually happened my sophomore year, but the nightmare is nevertheless unnerving at 49 years old.  A rarer nocturnal gem, arrives without warning and involves having my teeth literally falling out as I am eating or speaking.

I am certain this relates to my lifelong phobia of the dentist.  This irrational fear plagues most people except masochists and hillbillies and certainly was a burden carried by our ancestors.  Ancient dentistry was at best, primitive. The term “Pearly Gates” must have its roots based in dental hygiene.  Heaven on earth meant clean pearly whites devoid of pain.  Hell was the frequent need of the farrier/cobbler/dentist who would use the same rasp to file a hoof and then extract your aching bicuspid.  Pain was character building and penance for decay. Medieval dentists yanked anything that even looked like it was thinking about decay.  Decay, whether it be moral or oral, was to be rooted out.

April, 1968. The blue postcard would arrive in the mail like the sinister letter filled with orange seeds in Sherlock Holmes and the Five Orange Pips.  It was a death notice.  My reaction was akin to the four phases of dying – disbelief, anger, bargaining and acceptance, usually all within about 12 minutes.  The author of the invitation from the House of Pain was Dr Allen, our dentist and a certain descendent of the Marquis De’Sade.

Our dentist sported an army crew cut and looked like an evil ventriloquist — grinning and flirting with our mother while saying under his breath…”You may feel a little sting”.   This Dr Jekyl would paternally put his arm around us and lead us into the dungeon while my Mom sat down to her Redbook.  Once in the chair, Dr Jekyl became Mr. Hyde DDS.

XRAYS were achieved by jamming into your cheek a T shaped piece of reinforced white cardboard the size of a shoe tree that caused immediate pain and involuntary tearing.  Then, came the probing of your teeth with a sharp pointed instrument to see if he could make you leap to the ceiling.  A mark on the wall presumably indicated the record for the longest jump once a nerve had been hit.  It was held by a fourth grader from Alhambra.. If he found an actual cavity, Dr Allen acted as if he had caught you stealing money from the orphans fund at church.  The greatest fear and loathing was just prior to a cavity being  filled.

“You know, Debbie, I don’t think we need any Novocain, it’s a small cavity.”

At this point, my eyes would bug out of my head like a cartoon character and I would furiously tap an S-O-S with my hand,  hoping my mother knew Morse code. I had no voice – – my mouth was full of cotton and my throat dryer than an Arizona rain culvert in July. ” Almoooost done” he would say absentmindedly, dismissing my protests and shooting a wink at lithe, little Debbie, his twenty five year old hygienist who was clearly not the sharpest instrument on the table.  I expect she thought a molar was an animal that lived underground inside the Arctic circle.

The dental trauma train just kept chugging along when in young adulthood I was told that I needed extraction of my wisdom teeth. My oral surgeon did not feel general anesthetic was required so he instead shot me up with a quart of Novocain. At this point my eyes were frozen in place.  I could only stare, dead from the neck up. He clamped my back teeth and literally put his knee on my chest as he yanked out and broke off each of my four wisdom teeth.  Suffering from extraction trauma disorder, I decided to boycott the dentist for several years which proved to be a very bad idea.  The day of reckoning resulted in five cavities and a near root canal.  I chose a new age, roller-blading, Dead Head dentist with a pony tail, who gave me headphones to wear during the drilling and enough anesthetic to numb every beaver in North America.  Yes, it was an expensive lesson but I was relieved that dentistry had advanced since the Dark Ages of Dr Allen.

What a difference a few years can make. My kids actually look forward to the dentist.  It is not fair. Their pitted teeth are treated with the equivalent of Kevlar to prevent any attack from plaque. They can eat sugar.  Today’s pediatric dentists are child psychologists and pain free practitioners.  “Where the heck was I”, I thought when my son needed emergency dental work after cracking his eye teeth.  The office had flat screens in front of each chair with head phones piping in Nickelodeon cartoons and what seemed like 12 hygienists – one to wipe my son’s nose, hold his hand and another to tell the pediatric dentist what fine work he was delivering to this very lucky boy. Excuse me? What about the leather strap and the glowing, red hot knife to dig out his broken tooth?

I have to admit, it is easier for me as well.  Nowadays, my wonderfully reassuring hygienist Donna coaxes me with regularity back into her dental chair.  This particular visit, she asks me if I have ever worn braces.  Given that my “use it or lose” flexible spending account was over funded, I decided to take the plunge and get adult braces. A day after getting fitted with my new acrylic tracks, I happened upon a group of my son’s 12 year old friends and showed them my recent dental work.  I got head nods and sympathy.  Everyone in this posse had braces and they immediately accepted me as an honorary member of the brace face home boys.   “Don’t kiss any girls (with braces) and check the mirror because gross junk will be stuck in your teeth all the time.  No tootsie rolls, Airheads, gum, or Salt Water Taffy.”  They shook their heads in solidarity.  “Got it” I said, “especially about the girls.”

That night, I dreamt a bizarre Kafkaesque nightmare where I was transforming into a horse with huge eye teeth, sort of like old Lampwick when he goes to Pleasure Island with Pinocchio.  Intellectually, I was completely prepared for the braces. Emotionally, my tongue and lips kept sending my brain signals that the Watts Towers had been constructed inside my mouth.  Somewhere, Dr Allen was laughing at me.

So aside from the sensation that the Metro North spur line is cutting across my gums, life marches on.  I mumble more, smile less and vainly try to perfect a laugh that completely disguises my tin grin.  It’s a lot of work. My wife tells me it could be worse.  “Look on the bright side” she says, with her disgustingly perfect teeth, “you could have to wear a head gear.”

She’s got a point.