Of course, most Ghanaians never see a dentist. Until recently their teeth weren’t subjected to processed foods with all that sugar and, anyway, apart from having a tooth wrenched out, there would be no thought given to any other treatment. It would be too costly.

I paid my first visit to a dental surgery for many years, here in Accra. Having seen my father have all his teeth removed, most of them healthy when still in middle age because in the nineteen fifties dentists were paid per extraction, a form of piece work, I have an abhorrence for a glass tumbler by the bed with magnified, grinning dentures. So I have opted for an expensive implant to replace what my Ghanaian dentist took away.

Back to the chronology of the visit. I registered and went into the surgery. The little theatre was very sparse compared with UK environs. I always remember the Monty Python sketch where doctors were clustered around a machine that went ‘ping’, their newest gadget. No-one had the slightest idea about what it did beyond making that impressive, technological noise. Well here there were no superfluous machines. I was screened off from the noisy patient next door who was making a noisy fuss. My dentist was most agreeable. He gave me a book on management leadership to read. He sang a South African traditional song as he skipped between patients. He murmured ‘sorry, sorry, sorry’ as he put the needle in various places that did not want to receive it. He told me how brave I was which made me feel as I did as a child when refusing to make any sound as bullies tried to Chinese burn my wrists into a torturous intensity.
Feeling the tooth coming out seemed to tell my brain that it was painful as I could visualise and isolate fibres and flesh and bone giving way. But, actually, it was tolerable. Then, amusingly, he asked me if I wanted the spare body part, showing me the tooth I had nursed for its last fifteen years. I declined the monster. It looked like an asteroid, pitted by a thousand encounters with space debris. But it left my body with a feeling of time passing and a nostalgia for those far off days when milk teeth had just popped out under pressure from the real thing. Funnily enough, while I had been waiting to go in to the surgery, I struck up a conversation with a pretty, eighteen year old student. She was having milk teeth removed because they didn’t want to give way to their elders and betters.

It is easy to feel isolated and mortally vulnerable, three thousand miles from a true national health system. You could spend all your time out here being an anxious hypochondriac. What is driven home to me is that in the west the whole of medicine is focused on the reduction of pain and any intimacy with it. Once, even in my lifetime, you would have expected some pain to be borne. Enough, not to fear it unduly. Enough to know that, once over, the body forgets almost immediately.

Today, people use anaesthetics to obviate pain: Cesarean sections, pills for sleeping. People become obese and a prey to disease and more anaesthetics as much because they don’t want the hurt of exercise as because they over consume junk food in the first place. It is all too painful to feel the heart pumping, the wracked lungs, the painful limbs when they can wallow in a painless hell of over indulgence.

I liked the dentist experience. It was man to man. It was pared down to essentials. I had to endure enough pain to act as a momentary epitaph at the end of my tooth’s life. But no more than that.