In 1903 the house was almost new. Still young, not married a year, Mr Franks and his new wife embarked upon their first project together: the setting up of a new dental practice, not more than a mile from the great names set in brass along the Brompton Road and Kensington Gore.
‘A damned fool enterprise,’ said her father to Mr Franks once the ladies had retired. As new father-in-law, not to mention guarantor to the rental agreement, he let no opportunity for criticism go by. ‘Anyone in town with any money has already had their teeth out by Weston or Dromley-Kent. Got themselves a nice mouthful of Vulcanite.’
His voice was dreary, heavy with port, sluggish through an ether of cigar-smoke.
‘You can’t pull a tooth twice, young man.’
Before they were married, Franks would have forced a smile. Now, he allowed himself a certain boldness, a shiver of conviction. ‘Sir, we shall not be seeking the custom of the rich.’
A chuckle, unamused, evaded the stout obstacle of the cigar. ‘Young man, I find your logic obscure. I fear for my investment.’
Franks began to explain. The science of preservation, the new materials. The middle classes who wanted painless care and would pay for cocaine, but wouldn’t complain at being treated by gaslight. Let Weston and Dromley-Kent buy electric motor-drills; normal folk would take the treadle and be glad of it. In any case, he said with warmth, those grand old men see no more than six patients a day at a guinea each, and break their backs bowing and scraping. Whereas he’d see fifteen in a morning: a bob a nob for the decently-waged, less for the others. Children too; he’d joined the new school inspection society, he’d run a list once a week, get the poor mites out of pain and back into their classrooms.
‘There’s more,’ he said in a rush of passion, ‘than getting fat off the proceeds of fat smiles.’
‘Is that a fact?’ His father-in-law rose, and the young man, his eyes smarting from the smoke and a feeling of having pushed too hard, stood also. ‘Your faith in the rewards of charity are humbling indeed, Mr Franks.’
‘This is not charity,’ he said, less certain now, ‘merely good sense.’
He watched the old man leave, hearing through the fireplace’s crackle a softly venomous mutter. Something about misplaced optimism. Something about picking up pieces, who would have to do it.
1948, and the queue outside the house stretched around the corner. Women, mostly, with their children squalling in their arms or scuffling around their legs.
‘Dear God,’ said old Franks as soon as William arrived. ‘What have you done to us, Master Atwood?’
‘You know it’s the right thing, Mr Franks,’ William said. He seemed to have been saying that for six months now, ever since he’d mooted the idea.
‘Is that a fact? Dear me.’ Franks took his arm. ‘You have yet to convince your father. He insists he won’t come in today.’ There was a shout outside, then a child’s outraged howl. ‘I’m beginning to wonder whether I should have.’
‘Mr Franks, you’re indispensable.’ William squeezed the liver-spotted hand. ‘We wouldn’t be Franks and Atwood without you, would we?’
‘Evidently not. But I am seventy, you know. Old dentists never die, William,’ Franks said, ‘but at a certain point they do seek to extract themselves.’
‘No-one’s pulling you out yet, Mr Franks. Anyway, I need you to talk my father round. You know he’s all for ripping up the government contract.’
‘My dear boy, what makes you think…’
A squeak of hinges, a slam that shook the walls. Atwood senior stood, snorting, in the hall.
‘What the devil has he done to us, Charles?’ He didn’t even take his coat off before hurricaning down the hall.
William felt Franks shudder. He held the old man’s arm a little tighter and stood his ground.
The argument, the latest of many, didn’t take long. There was nothing new to say, except that there were a good deal more outside than they’d expected. William’s father spoke only to his partner; if referred to at all, William was the new associate, the recent addition, or simply the problem.
Debate concluded, his father turned to William and raised a hand. ‘See that?’
William examined the squat, clever fingers. One bore a new ring.
‘Solid gold. Look.’ His father pulled it off and bit it. ‘I had the lab cast it up from restorations in teeth I’ve extracted over the years. Now, you – ’ He poked William in the chest. ‘It’s all very well crying give me your tired, your poor, your galloping gob-rot, but how’s it all going to end, eh? In ten years’ time Charles here’ll be long retired, I’ll be going too, and you know what you’ll be doing? Working out how to pay your bloody creditors, that’s what. Handouts and social theories don’t keep a business in the black.’
He pushed the ring back onto his finger. ‘There’s no gold in amalgam fillings, boy.’ His heels attacked the tiles as he stomped out.
‘Not to worry,’ Franks chuckled. ‘He’ll come around. Mind you, he’s right. I’ll not be here much longer, and that’s probably for the best. But, you know…’ He tailed off.
‘Yes?’ William prompted.
‘Ah!’ Franks patted him like a good dog. ‘You know, if I were your age again…by gum, I’d be right beside you.’
‘We’re not open till nine!’ Their receptionist bustled in, barking at the family at the front of the line who were making a push for the door.
‘Oh, let them in,’ said William, rolling up his sleeves. ‘Let’s make a start.’
‘Trust me,’ said the man, ‘1998 is the year places like this are going to explode.’
David tried not to look alarmed. He frowned at the card thrust into his hand: ‘TBMT Marketing Consultants’.
The woman, older than her colleague, led the way. Stiff back, stiff hair, heels clipping the tiles. ‘Of course,’ she said, glancing at the waiting room, ‘this would all have to go.’
The man grinned. ‘You were right to bring us in, Mr Atwood. We’ve had some brilliant ideas. So much potential.’
‘Mm,’ said David, uncertain. ‘It’s been a very successful practice.’
‘And, as practice principal, you want it to remain so,’ said the woman, leading them down the corridor. Her tone was that of a maiden aunt prevailed upon to look after a dimwit nephew: thinly patient, politely underwhelmed. By contrast, her colleague’s voice made elastic attempts to catch your attention, like an inexplicably chummy bloke down the pub.
‘You see, Dave – I can call you Dave, can’t I?’ said the man. ‘The way things are moving, it’s all centralising. Polyclinics, centres of excellence. One-stop health shops. Dentistry, chiropody, whatever. Homoeopathy, reflexology…’ His hands sliced the air as he spoke, dividing it up.
‘Sorry,’ David interrupted him as they entered Surgery One. ‘You’re putting all that into NHS dental practices?’
‘Don’t just think dental, Dave.’ The man spread his arms wide. ‘Dream large. And hey – we’re not just talking NHS here. Think partnerships, public and private, hand in hand. I don’t think we should be excluding services that people see benefit in.’ His sharp eyes smiled.
‘What I’m trying to say,’ David said, ‘is this place has always been about evidence-based care. I mean, my father was one of the first – ’
The man nodded, immediately grave. ‘Yes. And you know what? It’s the values of your father’s generation who brought the NHS this far. Without the William Atwoods, none of this would be here today. But, you know…’
He placed his hand on David’s arm. It stayed there, a solid pressure as if David were a barrier he were testing the resistance of.
‘If your father was here today, he’d be going where we’re going. Innovating healthcare for the twenty-first century. Creating visions. Taking them forward. Because we all want the same thing, Dave, yeah?’ The hand slipped up to David’s shoulder; any further and he would have had his arm around him. ‘Quality healthcare, affordable, there for everyone. For our families. For our children.’
His voice had hoarsened. For a horrible moment, David thought the man was going to weep.
The woman gave a small cough. ‘I think my colleague is saying that our evidence suggests alternative therapies are some of the fastest-growing, most profitable sectors in modern-day healthcare.’
‘I wasn’t talking about profit…’
‘Profit, Mr Atwood, means money for this clinic. More money, as I’m sure you appreciate, means more clinicians. More services. More patients receiving more and better treatment. It’s really not complicated.’
She turned away to inspect a dado rail, running a finger along it as though checking for dust.
‘Look, Dave.’ The man’s hand was back on David’s arm, escorting him out into the hall. ‘Bottom line, we absolutely believe this is the way ahead.’ The smile again. ‘You can absolutely trust us to deliver.’
Nausea rose in David’s throat. He wanted them to leave. His stomach growled, loud and embarrassing in the closing-time quiet. The man laughed, and David felt obliged to as well.
‘Sounds like you’re ready for something to eat. Follow me.’
As promised in their leaflet, they had brought a complimentary buffet supper. David allowed himself to be extracted from the room, feeling the redesigning eyes of the woman at his back.
The removal lorry’s back doors gaped, swallowing furniture, desks, old computers.
‘None of it’s worth a thing, David,’ Jenny said to him for the third time that week. ‘Let the developers shift it.’
David tugged his grey beard. ‘We’re supposed to leave the place empty. And there’s nothing wrong with this stuff, it’ll come in for something.’
Jenny did that thing with her eyebrow, just as she used to when David asked her to squeeze a thirty-minute crown-prep into a fully-booked day. ‘TFT monitors? iPads? They must’ve been here longer than I have, and I started ten years ago.’
‘Not ten years.’
‘Yep, 2015. The year you did that nano-research-thing with the hospital.’
‘Oh, the self-assembling enamel peptides. Fancy you remembering that.’
‘I was very impressed. Painting bad teeth with nano-whatsits to regrow enamel. Thought you were quite the dashing pioneer.’ She glanced at him. ‘Didn’t last long.’
‘Neither did the peptides. Study folded after six months, didn’t it?’
They shared a smile.
‘There’ve been a few successes, though, haven’t there?’ David didn’t like the beseeching note in his voice. ‘We were in at the start when they introduced ID-chip veneers.’
‘And we were the last practice round here to still have NHS patients, before that all finished.’
There was pride in Jenny’s voice. It made him sad.
‘Yes. That too.’
She didn’t look at him when she said, ‘You could carry on, somewhere else. Ultrabrite’d have you, now McReady’s going.’
He shook his head. ‘No. I’m sixty-six; I can’t begin again.’
‘Why not?’ She sounded angry. ‘Why should age matter? If you’re still good enough, why not keep going?’
‘Oh, I don’t know. Out with the old, in with the new.’ He tried a chuckle. ‘I’ll scrimp till they give me my pension and then…’
‘Something like that.’
Once the men had filled the lorry’s maw, David went back inside to lock up. Jenny called goodbye from the front step.
‘Don’t hang around too long,’ she warned him.
But he did. He lingered till the sunlight died, pacing room after room, examining stains where chairs and cupboards had sat, mentally reconstructing the place. They should have had Surgery Two the other way around; better, surely, with the chair facing the door. That way you could fit a desk in, and that’d free up the consulting room, which meant –
Stop it. Pointless. All over now.
His shoes on the tiles reverberated, too loud. He took his coat from the hook by the door and remembered his father.
The Yale lock clicked home, soft as a root snapping. David hurried away and didn’t look back. SLQ
Daniel Knibb is a proud member of the NHS, and in his spare time writes short fiction and poetry. In recent years his work has found success in the Sentinel Quarterly poetry prize, the Harry Bowling Prize and short story competitions from Cardiff Women’s Aid, Writers’ Village, Leaf Books, Sentinel Quarterly and Exeter University. He lives in Devon.
“Extractions” by Daniel Knibb won first prize in the Sentinel Annual Poetry Competition 2015 judged by Alex Keegan.