by Michael Doherty

Dr. Werner Knight, DDS, showed small concern for my fifth cranial nerve, branches of which end in tooth #26, the first upper-left molar. He told me this tooth needed a crown, on account of vertical splits from enamel to marrow. The procedure, he assured me, would fix #26’s sensitivity to cold, chewing probably wouldn’t hurt, and he would preserve the nerve, perhaps unlike a root canal, which he was confident I didn’t need. A crown sounded much easier and more elegant than a root canal. That’s why I’m in this dental chair, in a bib, my fists clenched in a state of considerable anxiety. A high-velocity drill, the very end of which was capped with a diamond bit called the double inverted cone, approached my open mouth. Dr. Knight was about to reveal that although yes the tooth itself had poor skeleton, the nerve to it was fine.

He wouldn’t hear my protests anyway, with the zizzle of the drill, the suck of the vacuum, and the treacle of music piped in to calm nerves. On came Bob Dylan’s ballad of Hurricane Carter’s injustice. The song is one of pain and imagined peace, with a brief lyric on a paradise with trout streams. Dr. Knight, clearly a fan, silenced his instruments, sang and/or mumbled along, all the while conducting with the drill in his steady hand. His level of excitement built along with my pain. Now and then he’d depress the foot plate that activated the drill, sometimes alternating with the suction, and in so doing, he injected percussive elements that eroded any calming effect the song might have had. Plus his timing sucked. In his own mind he was maestro of more than just dental arts.

I knew what would come next. After boring the walls of enamel off #26, and having sung the word trout, Werner Knight, DDS, would segue into one—or perhaps more—fishing tales. The physical pain was extraordinary, and the mental pain would worsen. I was sure his tale would involve steelhead and fly fishing, and there were about even odds I’d heard it before.

The first and last time we met, he told me how he fished Washington’s Grande Ronde River for steelhead. Before I learned I needed a crown, he told me of his two-handed Spey rod, the Scandi heads, his D-loops and snaps, and ultimately how he abandoned the swinging of streamers under the beautiful canyon’s half-light and the river’s dull rumblings for his one-hander and a setup involving bead “flies” drifted under an indicator.

“They are efficient . . . but so much mending, always mend, mend, mend with that method . . . it’s so effective for steelhead . . . yes?”

I nod but with the dual inverted cone bit grinding into my tooth, my left eighth cranial nerve, the auditory nerve, started ringing. I was definitely not mending. With that tinnitus, I misinterpreted Doc Knight’s last sentence as procedurally important, not a stylistic review of his preferred fishing methods.

This is what I heard:

“The medicine is not so effective . . . still need more . . . yes?”

I nod, which he takes as an encouragement.

“I find swinging boring.”

If I wasn’t in pain, I might have laughed. Dental conversations are absurd, lopsided (dentists should be rated by their ability to monologue). He nods his head as though a dislike of swinging was our strongly cured bond. And Dr. Knight continued with the same story I heard two weeks prior.

You could basically tell me what’s going to happen. Here are the elementals:

. . . indicator vanished . . . NO snag . . . shot like a rocket . . . like a runaway train . . . reversed . . . thought I’d lost it . . . fish still on . . . reel screaming . . . epic battle . . . cartwheels . . . leaps . . . thump-thump-thump . . . man vs. beast . . . subdued . . . netted . . . tailed.

My take on his second telling of the story?

The fish, on its breeding run, was played to exhaustion. Not just that. Doc said it was 33 inches and 25 pounds. A head nod away, in a small frame above a tray of talonlike surgical instruments, is a photo of Werner holding this unclipped beast out of the water. In my dead-sober, poorly anesthetized, pain-goggled reckoning, it’s 20 inches, 6 pounds, maybe 6-and-a-half. It’s not a broomstick, but about right for a survivor of 2015’s warm Pacific Blob. About average for a summer run past the eight dams between July’s Pacific and October’s Grande Ronde to that spectacular canyon.

The exaggeration of the steelhead tale bothered me. The story’s repetition cemented impressions I was getting of Dr. Knight’s painful mediocrity. I don’t mind if clearly spruced fishing yarns are told by one-upping friends around a campfire. Two-way amiable bullshitting holds a sacred place in the rituals of fishing friendships. But dentistry has different customs and all of them revolve, I hope, around truths, or at least probabilities of truth: the correct diagnosis, the best treatment, the expected outcomes, and so on. Yeah, I know, kinda goofy, but bear with me, here’s the float of my logic raft: the truth of your doctor’s fishing tale parallels their competencies.

I’m in pain. I’m wondering about the competencies of Werner Knight, DDS, who never included in his consent that at most he would inject 1 cc of some kind of numbing oil called astrocaine in his description of technique. He sprung that on me today. Apparently if I received more I might anaphylax and stop with the breathing. At this point I was absolutely willing to take whatever probabilities gave me a shot at less pain regardless of risks of breathing cessation. The problem was, I couldn’t communicate this to Dr. Knight.

Worse yet, today’s effort was only a temporary hold, stage one, with a crown that wasn’t even tooth colored. Instead, it would be metal, a sort of a cutthroat gold. He reassured me this was safe as can be, so long as I avoided eating metal, unpleasant galvanic jolts like needles of evil pain remained unlikely. In the meantime, before my gold-ish crown was seated, he’d take a mold of the tooth’s core, send it to a factory in Spanaway where they’d shape a cream-white cap for #26, which, he assured me, would fit perfectly, for a decade and then we would probably do a root canal or an implant.

“You like that plan?”

I didn’t answer. A pair of rake retractors held my orbicularis oris muscle as wide as can be. My tongue was confined below a drum of verdant nitrile stretched between my bottom teeth. My lips, smeared with a version of grease that would, he reassured me:

“Suppress chapping and in a pinch, float a dry fly, no problem, no problem at all.”

“You ever skate dries for the steelhead?”

“Me neither . . . this fall, on the Skeena . . . I will skate dries there.”

All those beautiful rivers with perhaps still some steelhead in them to be harassed by men with means, dry lines and dental grease smeared on a moth pattern. I was conflicted. Sure, would I like to fish the Skeena with anything, let alone dries? Would I bead if I wasn’t catching squat?


But on the other hand, why? What reasonable or ethical stance could I justify traveling hours, days even, pursuing a fish that was in rapid decline in terms of numbers, but had assumed mythic proportions in the minds of fishermen, fly or otherwise? I thought of the Skeena or the Dean or the Kispiox or Skagit, their greasy turquoise waters, hills half logged of cedar and Doug fir, wisps of cloud trapped among them and dull, relentless coastal rain. What would it take to survive there?

I opened my eyes and despite watts of surgical lighting, I could see lenses of sweat mushroom out of Werner Knight’s forehead pores. Past him, though, past his facemask, past his steel tray of terrifying tools, there was a poster with a French title, Les Poissons Toxiques, which meant, I assumed, The Poisonous Fish.

On it were strange and bizarre creatures. More specifically, box-, toad-, and pufferfish, and under each one was a tortuous old-timey font with the fish name, dozens of names among them: the salacious, such as Ostracion quadricornis (the Cuckold-fish) and Tetrodon hispidus, (the Sea Weather-Cock), and the familiarlike Diodon mola (the Sun-fish).

These prints were classics from Marcus Elieser Bloch, a German physician and naturalist, who published them in the 1700s. That part was on the poster too. The images were stunning, the sort of fish version of a John Audubon bird print, but with strange tetrahedral and buckyball-like shapes, camouflaged with textures and colors ranging from brown to orange to yellow; skin more like softshell turtle scutes than scales of a fish. Some of them were covered in spikes, some had horns, all were huge eyed and fan-tailed with bodies not built for speed.

Dr. Knight saw the direction of my gaze, continued his monologue.

“Those fish . . . are not for the fly fisherman. . . .”

“Suction please!”

It’s just me and Werner in the room, but he said it like a weary dental assistant would soon oblige. He held out his hand, palm up, then some of the most essential lignum vitae cogs and gears must have meshed with the slow belts inside his skull, and the wooden machinery within him ultimately produced movements. His hand pronated back to the suction tube still resting in its holster, still clipped to his instrument tray, right where he left it.

A 1781 illustration titled

“Those fish, they can kill you . . . ”

An explanation would be delivered through stabs of pain, the hum of the vacuum pump, the gurgle of evacuating spit, and the smell of smoldering just-drilled tooth, where the deep inverted cone bit wouldn’t cool with lukewarm irrigants. Oh what I would give for an escape, for more Astracaine, for a complete nerve block, Percocet, Valium, the bosom of a dental assistant pressed into my shoulder. Even delusional Skeena I’m here to fish in the snow, damn it hypothermia would work. But there was no prospect for relief.

Fugu . . .

His accent and a way of almost shouting it made fugu sound like a curse, made me think I jeopardized the Doc’s surgical field and frankly startled me.

“You know—Japanese pufferfish—if you eat it from the sushi chef . . . if he’s too young . . . doesn’t know what’s up . . . serves you some fish liver . . . you eat it, the toxin gets in you . . . that paralyzes you . . . tetrodotoxin . . . first your tongue tingles . . .”


His hand supinates and pronates. The suction tube has never left it.

“. . . then you die in minutes . . . nothing moves . . . motor paralysis. Worse than anaphylaxis.”

He is gesticulating with a new instrument that ends in a metal hook in one hand, the clear plastic suction tube in the other. He puts down the curved implement and does a double haul of a move to pull more suction tube, it clanks somewhere unseen, free spooling some loops of hose out of the trunk of his fully operational dental station. The suction gurgles some apneic little farts before it synchs up to the compressor pump, pulling my spit, the lukewarm irrigant, my blood, my fragments of ground tooth toward the sea, toward this year’s new Pacific blob.

“It’s fascinating, those fish, the teeth . . . those teeth always grow . . . they never need a crown like your #26 here. . . .”

He laughs. I can feel him tap it with one of his talon-shaped tools, like a used-car dealer kicks a tire, only his boot is a tiny needle of titanium. It’s an absurd moment, and even if my jaw was mobile and my tongue free, there’s nothing to argue about.

“But still . . .”

“You are a fisherman, yes?”

I nod. I have told him this before. Confirmed it even earlier in this very visit.

“I like the steelhead. With my fly rod. You fly fish?”

I nod. Knowing full well exactly what is to come. Werner Knight, DDS, is going to tell me for a third time in two weeks and the second time today how he floated an egg pattern under an indicator on the advice of an October guide he hired on the Grande Ronde.

It occurred to me that Werner Knight, DDS, didn’t need a guide on the Skeena so much as a competent neurologist and some sort of career intervention. Despite his oblivious dilemma, my obvious one remained. The cast for the new crown was just now molding to #26’s fragile skeleton. The crown itself was still to be made in Spanaway, two weeks from now. And one thing that I hoped would not fail in that time was Dr. Knight’s procedural memory, his muscle memory. I could handle the crown placement to come if I knew his motor skills were still good. I could handle it even more if my primary care doctor saw merit in my pleading for two pills of opiate-based medicine.

I stare hard at that poster. Through the pain, I concentrate on Diodon orbicularis, the prickly bottlefish. Years ago I’d seen fish like those chase a crab pattern through warm water. All line pulled in, I dangled just my leader and swirled the fly around them, playing with them, watching them chase. You can tease coho and coastal cutthroat like this, but when those fish see you’re involved, they bolt. Not Diodon orbicularis, though—they don’t spook at the sight of my poor skeleton.

Diodon orbicularis could move forward and back, up and down. They rotated. Steelhead don’t do that. These puffers lived at the boat launch, where the outflow pipes dumped, under creosote piers, beneath sheens of engine oil, below floating rafts of tsunami junk, beside hulls in need of scraping. They clustered by the cleaning station scavenging under arcs of thrown offal. They didn’t need to migrate, they could care less about dams, and they didn’t give a damn if you were a swinger, beader, or flosser. Apart from me, no other fish or birds or humans toyed with them. One of the two species would still be here in one hundred years, and I reckoned it wouldn’t be the steelhead.

Later that same day I walked the sandy beach, on the firm side of the high-tide line. Washed up among cuttlefish blades, detergent bottles, seaweed, and yet-to-bleach shearwater carcasses were two of these pufferfish, dried and expanded, their last failed act of attempted survival to puff up and intimidate. They remained stuck in their rictus, their death tetany, bleached in the sun, big as rugby balls, their weird flat heads crowned with Jesus rafts of dried seagrass impaled on their dorsal spikes. Even the flies avoided them, and unlike the shearwater skulls, their big eyes remained unpecked.

Their teeth though, four of them, the tetraodons, two up, two below, were magnificent. Big chicklet-shaped things, bright white, strong, built to munch algae off coral, to crunch shells, cut flesh off carcasses, crack crabs open, to bust bones and gorge on marrow. I didn’t know then their teeth always grew. Their teeth look human. If our teeth always grew, there would be no need for Werner Knight, DDS.

I would imagine while the Doc worked on the last stage of my new crown, how those two Diodon orbicularis met their unheroic and toothy end. I guess an alternate mental exercise was how the Skeena or Grande Ronde steelhead finish their story. The death of steelhead leaves me with little solace. I don’t see things ending well there, let alone the few that Werner Knight, DDS, might hook. At least with these weird tetraodons, Les Poissons Toxiques, their skeletons weren’t fragile. Like rats and rabbits, creatures whose teeth always grow, these fish are built to survive.

Michael Doherty, a neurologist living in Seattle, Washington, is a two-time recipient of the Robert Traver Award. He mainly treats people with seizures, and when he’s not doing that, he’s out fishing with his son. Or doing yard work. Or thinking about how to write a fishing story that isn’t exactly about fishing.