Be the one

Be The One: Serve
By John Maxwell, June 1, 2010
In life, it's not what happens to you, but what happens in you and through you that counts. When adversity visits your life, you have two choices: to be a victim or to be a victor. Victims allow circumstances to get them down, and they spend their lives asking others to redress the grievances life has dealt them. Victims are needy and demand to be served. Victors, on the other hand, rise above the challenges they encounter. They rebound from life's hardships with newfound strength, and they use their strength in service of those around them.
Juliette Magill Kinzie Gordon was born in 1860 to a wealthy family in Savannah, Georgia. Far from the typical Southern belle, Juliette was willful and tomboyish, always in search of adventure. She was the type of person never to be caught sitting still; she enjoyed trying new things and traveling new places.
In her mid-twenties, the first of a series of misfortunes struck Juliette. Suffering from chronic earaches, she sought medical care, but doctors mistreated her. As a consequence, Juliette lost the majority of her hearing in one ear. The following year, Juliette was married, but as she and the groom exited the ceremony a grain of rice, tossed by a well-wisher, lodged in her good ear. While attempting to remove the grain, a doctor punctured her eardrum, and Juliette lost hearing in her second ear.
For someone who enjoyed an active lifestyle, deafness could have been devastating, but Juliette persevered. She moved to her husband's estate in England where she became a favorite in social circles. Her humor and vivacity made her a sought-after guest and celebrated hostess.
However, Juliette soon crossed paths with tragedy again. Her husband's alcohol abuse and infidelity contributed to the gradual decline of their relationship, and in the middle of divorce proceedings, Juliette's husband died from a stroke. To make matters worse, he bequeathed his substantial estate to his mistress rather than giving it to Juliette.
Having lost her hearing, her husband, and her home, you would have expected Juliette to feel bitter and victimized. However, at this very point in her life, she chose to serve. Somehow, she moved past her own tragic circumstances to see the good she could do for others.
Having befriended Sir Robin Baden-Powell, founder of the Boy Scouts, Juliette became intrigued by the Girl Guides, Britain's sister organization to the Boy Scouts. The Girl Guides program awakened passion in Juliette, reminding her of youthful adventures from days gone by. With the help of Sir Baden-Powell, Juliette returned to the United States with a notion to launch the Girl Scouts.
Over the next 15 years, Juliette devoted her life to pioneering the Girl Scouts of the USA. She founded its inaugural troop, authored its bylaws and handbooks, and solicited its startup funds. Thanks to her tireless recruiting and relentless campaigning, the Girl Scouts program blossomed. The organization was such a source of joy for Juliette that, when diagnosed with cancer, she hid the illness as long as possible in order to continue advancing the scouting movement. While she never had children of her own, by the time of her death Juliette had an "adopted family" of more than 160,000 girl scouts. Her legacy lives on today in the 3.4 million young ladies who belong to local Girl Scout troops in America.
Study may shed light on when it's appropriate to remove wisdom teeth
By Laura Hambleton, The Washington Post, June 1, 2010
Bethesda oral surgeon David Ross studied the X-ray of my 17-year-old daughter's mouth. She had 28 fully grown adult teeth, with long roots, looking pretty straight after a few years of orthodontia. In her upper jaw, though, two errant teeth floated above the rest out of alignment, lurking in the shadows.
"These teeth are completely impacted," said Ross, pointing to where they hid in her upper jaw, to explain his recommendation to pull them. "In this position, they probably aren't going to drop down."
Or they might. And if they do, my daughter would have two perfectly functioning molars at the back of her upper jaw.
But if the teeth don't come through or push through only part way, they might cause problems down the road. Ross showed us the X-ray of a 75-year-old man who left in place a wisdom tooth that was now growing sideways, surrounded by a cyst. The man's jawbone could be in jeopardy, and so the choice was clear: The tooth needed to come out.
For my daughter and me, the decision was not so straightforward. We had to weigh the risks of possibly unnecessary surgery against the advantage of taking the teeth out then, while their roots were less formed and easier to pull, in the hope that she would avoid problems--ranging from infection and damage to adjacent teeth to cysts or even tumors--that might, or might not, happen in the future.
This is the dilemma for those whose wisdom teeth aren't causing them problems.
Dentists often recommend that young people get those teeth pulled, particularly before they head off to college for the first time. Yet, as I discovered when trying to decide what to do with my daughter's two errant teeth, there just aren't any etched-in-stone, must-do rules, good scientific studies or even helpful statistics to indicate when it is reasonable to pull a wisdom tooth and when you can leave it.
A controversial 2007 article in the American Journal of Public Health by retired dentist Jay Friedman likened pulling an asymptomatic wisdom tooth to removing a healthy appendix just to prevent the future possibility of appendicitis. "If there's no evidence to support a surgical procedure, then it should not be done," he said. But others say that there aren't enough data to support that conclusion--or any other at this point.
The National Institutes of Health hopes to fill in some of these statistical and clinical gaps through a study it launched a year ago that is following 750 dental patients in five northwestern states. The study will look at the reasons given by general dentists when they recommend either keeping or pulling third molars and what the patients then decide to do. It will follow those patients for two years after their decision to assess rates of complications, according to Greg Huang, principal investigator for the study and head of the Department of Orthodontics at University of Washington School of Dentistry.
"There isn't any good information about the life cycle of third molars," said Donald DeNucci, a periodontist with NIH'S National Institute of Dental and Craniofacial Research in Bethesda. "In Great Britain, they have been looking at this closer. They state that if a wisdom tooth has a cavity or is causing swelling of the gum or has periodontal issues, remove it. Then things move into the gray area, where it's not so clear. In Great Britain, the National Health Service now says if impacted wisdom teeth are not causing problems, don't remove them." DeNucci said the NIH study will help oral surgeons and dentists in this country make informed decisions about wisdom teeth based on scientific evidence.
Most people are born with four wisdom teeth, or third molars, which ordinarily begin to come into the mouth between ages 17 and 25. "They are called wisdom teeth, I suppose, because they come in during the late teens and 20s, when a man begins to possess some wisdom," said DeNucci.
Wisdom teeth can become impacted--or trapped in the jawbone, unable to grow above the gum--for a variety of reasons, most commonly for a lack of space or because another tooth is in the way. Or the teeth grow in a skewed manner, sideways in the gum or at a slant toward adjacent teeth.
Chevy Chase dentist Steven Kahan, who has been practicing for 40 years, said: "It is the kind of thing where all of us make a somewhat educated guess. You can't always predict how a tooth will grow. I have one wisdom tooth locked in my upper arch, and it's been there forever. The advice of the oral surgeon when I was in dental school was to leave it alone. I've never had a problem."
Yet it is clear that there can be problems.
"Sometimes a sac forms around a wisdom tooth," said Washington dentist Richard Steinlen, who estimates he has cared for about 4,000 patients a year during his 28-year career. "Mouths are more cyst-prone than other parts of the body. Lots of cysts form around wisdom teeth."
Partially erupted wisdom teeth also create troubles because they are hard to clean, he said. As a result, food can get lodged in the back of the mouth and create a perfect environment for a bacterial infection called pericoronitis, which can cause pressure, pain and swelling. (Antibiotics are often prescribed to treat it.) In addition, partially erupted wisdom teeth are prone to tooth decay.
Thomas Dodson, a professor of oral surgery at Massachusetts General Hospital and author of an April study in the British journal Clinical Evidence that reviewed other studies on impacted wisdom teeth, found that 25 percent of patients who had wisdom teeth without symptoms had periodontal disease on those teeth.
According to Dodson, this shows that the absence of symptoms does not mean the absence of disease. As a result, he said, patients who keep their wisdom teeth should be monitored periodically to assess the health of those teeth.
Often when Dodson tells patients with asymptomatic wisdom teeth that "there are no data" to help them decide whether to pull the teeth, "60 percent elect extraction; 40 percent choose to retain the wisdom teeth and schedule a two-year follow-up visit with me," he said.
Dodson noted that whatever the patient decides, the surgery has become easier.
Still, pulling a wisdom tooth is surgery, and surgery can lead to problems. Wisdom teeth in the upper jaw can be very close to sinuses, which can get perforated during surgery. The lower teeth, meanwhile, lie very close to several nerves; damaging them can cause temporary or even permanent numbness in the lips, tongue or chin.
"But the most common complication is infection," Dodson said, and "that happens one in 20 times. Then there can be postoperative bleeding, nerve injury and a host of rare complications, such as a possible break in the jaw. Dry socket [which occurs when the blood clot that is left after a tooth is pulled dislodges and the bone is exposed] and infection can be as high as one in 20."