Flannery O’Connor, the American writer and essayist, said, “Writing a novel is a terrible experience, during which the hair often falls out and the teeth decay.” Many would agree with her; the time from the germination of an idea to completion or publication can seem like an eternity.
Given my background in dentistry, O’Connor’s mention of tooth decay grabbed my attention, and had me champing at the bit to write a few words on the subject.
The processes involved in forensic odontology—pouring models of bite marks to help prove an offender’s guilt, identifying remains through dental records, and determining a person’s age by the eruption sequence of their dentition—are all fascinating. From braces to porcelain crowns, and from thumb-sucking babes to edentulous (toothless) old witches with warts on their noses, dental matters can be surprisingly important to a writer and play a big part in plot and character development.
Talking through gritted teeth, baring your teeth, clenching, grinding, chattering, lying through your teeth, a kick in the teeth, and teeth-brushing in one’s pyjamas are all images that convey emotion and action.
Teeth also give us some great descriptive words and phrases which help to visualise a character: pearly whites, nicotine-stained, gap-toothed, overbite, yellowing, false, prominent, crooked, buck-toothed, dazzling, crowded, overlapping, horsey teeth, and vampire canines.
A more recent term, “meth mouth” is typically characterised by a mouth full of broken, dislodged and rotten teeth, which occurs because the drug methamphetamine reduces salivary flow, leaving the mouth’s acids to dissolve the tooth enamel, causing rampant caries (decay).
Human teeth are not the only ones of interest to the writer. A Rottweiler and two Spanish bull mastiffs snarl, snap, and crunch their way through parts of my books Star-Crossed Lovers and Death-Marked Love. In Natalya I have wolves tearing at flesh.
Elephants’ “incisors” are their ivory tusks, which can be used as weapons and as tools for digging and moving things. (This is, of course, their real purpose, rather than to be ornaments on someone’s coffee table.) Along with the tusks, elephants have twelve deciduous premolars, and twelve molars, which can weigh up to 5kg each. Elephants are polyphyodonts, which means they have cycles of tooth rotation. The chewing teeth are usually replaced six times in an elephant’s life. The last set usually arrives when an elephant is in its forties and must often last until seventy years of age or longer.
While I was visiting the Ngorongoro Crater in Tanzania, my guide explained that many older elephants’ teeth wear out and they become attracted to marshy areas with softer grasses they can continue to eat. But sadly, many elephants with worn-down teeth die of starvation.
Teeth scenes are the stuff of nightmares and fairy tales. Who could forget when Little Red Riding Hood said, “Oh, Granny, what big teeth you’ve got!” and the wolf replied, “All the better to eat you with, my dear!”
Dental torture is a cinematic favourite. A classic example is the interrogation scene in John Schlesinger’s thriller classic, Marathon Man (1976). The whir of a high-speed drill, the crunch of a molar being extracted, or the sight of a screaming, drooling victim are enough to send shivers up the spine of the most hardened moviegoer.
Needle phobias are common among dental patients. “Open wide, this might sting a bit,” the dentist says, and all of a sudden your lips feel like rubber. But imagine undergoing root-canal treatment of a vital nerve without anaesthetic. A tungsten or diamond-tipped burr cutting through the enamel would be relatively painless, but once it entered the dentine, the discomfort would gradually intensify. Exposure of the nerve, a bloody mass encased in the pulp chamber, would be excruciating.
And I’m not at all sure the sadistic interrogators of film and literature would be aware of the correct extraction technique. It’s not a simple case of yanking a tooth out. First, the forceps must be secured around the crown. Then you push, twist, twist again, again, break the ligaments—pop!—then you remove the tooth. Incisors with their single roots are not too difficult to get out, but lower molars with double roots and upper molars with three roots can be a challenge even for the experts.
The state of a person’s or character’s dentition says a lot about them. It indicates socio-economic background, age, self-esteem, diet, hygiene, income, race, where they grew up, and any history of substance abuse. According to Flannery O’Connor, even one’s profession can make you susceptible to tooth decay. Writers beware.
Agatha Christie offered some dental wisdom in The Patriotic Murders when Hercule Poirot said, “No, my friend, I am not drunk. It is that I have been to the dentist and I need not go for six months. It is a beautiful thought.”
Very high on the list of my favourite New Zealand pastimes is spending time with my dog, Absinthe. She’s currently living with her extended family and enjoying five acres of snake-free, spiderless, lush emerald pasture. Abbie’s had a pretty tough week, a couple of teeth extracted, and she cried through her hair cut. She’s happy now, though, toothless grin and all.
Strange Case of Dr Jekyll and Mr Hyde, an 1886 novella by Robert Louis Stevenson, made such an impression that today, the term ‘Jekyll and Hyde’ is part of our language. The phrase continues to refer to a person who exhibits markedly different displays of moral character.
Part of Stevenson’s inspiration for the story came from observing mental health patient Louis Vivet, who was one of the first individuals to be labelled with dissociative identity disorder. Termed multiple personality disorder or split personality disorder at the time, Vivet’s diagnosis soon appeared in psychological literature.
The novella has been interpreted as an exploration of the duality of human nature, the internal battle between good and evil, and our tendency to banish dark thoughts and intentions to the unconscious mind, from which they may later manifest in aberrant behaviour.
Now, let’s fast-forward to Robert Bloch’s 1959 suspense thriller Psycho. Who could forget the shower scene in Alfred Hitchcock’s screen adaption of the same name? Antagonist Norman Bates suffered abuse at the hands of his dominant mother, murdered her, and developed dissociative identity disorder. He would talk to himself in his mother’s voice, and wore her clothes when he stabbed hotel guest Mary Crane to death.
Bloch’s writing was inspired by the concept that a monster could live next door, unsuspected, even in a small town. Coincidentally, two years before Psycho was published and unbeknown to Bloch until later, a deranged killer was arrested in a village near his home in Weyauwega, Wisconsin. Ed Gein was found to have been making furniture and clothing from human parts and skin. Medical experts at the time believed he was trying to make a “woman suit” so he could pretend to be his puritanical dead mother. Thomas Harris’s character Jame Gumb, referred to as Buffalo Bill in The Silence of the Lambs, was also influenced by Gein and several other real-life serial killers.
One of the scenes from Silence of the Lambs that has stayed in my mind is the kidnap of Catherine Martin. Gumb used his usual modus operandi. He pretended to be injured and asked for help, a ploy used by Ted Bundy, then knocked his victim out and abducted her.
We met another of Harris’s characters, Hannibal Lecter in Red Dragon, and again in Silence of the Lambs, when Clarice Starling interviewed him during the search for Catherine Martin. Lecter, a forensic psychiatrist and cannibalistic serial killer, commented on Gumb by saying, “Billy was not born a criminal, but made one by years of systematic abuse.”
Lecter’s own development as a serial killer is revealed in Harris’s 2006 publication, Hannibal Rising. Eight-year-old Hannibal endured unspeakable trauma. After his parents had been killed by a German bomber, he and his sister Mischa were held captive by Lithuanian looters.
Mischa was murdered and cannibalized. Hannibal escaped but was rendered temporarily mute by the ordeal, which scarred and haunted him for the rest of his life. Lecter committed to exacting revenge for Mischa, and tracked down and killed her murderers. In Hannibal Rising, Lecter presents as an antihero: although his actions are not morally correct, the reader empathises with his motivation.
My own novels Star-Crossed Lovers and its sequel Death-Marked Love also explore the catastrophic effect of childhood trauma on an individual’s psychological make-up. In the case of Katie Garcia, she is unable to face her devastating reality and a new identity emerges: an alter ego with the capacity to be vengeful and murderous. Her condition is complicated by selective mutism, a traumatic brain injury, and the possibility of post-traumatic stress.
Violence begets violence, but not all victims of assault will become perpetrators. Most won’t. So, when writing her, I had to ask myself, did Katie have a genetic predisposition toward mental illness? Were there existing homicidal tendencies lurking below an innocent exterior?
The 1973 book Sybil, by Flora Rheta Schreiber, focused on the life and treatment of Shirley Ardell Mason for multiple personality disorder, now referred to as dissociative identity disorder (DID). This is considered a pathological, involuntary defence mechanism. Mason’s symptoms before diagnosis included social anxiety, ‘losing time,’ and bouts of depression. Psychoanalyst Cornelia B. Wilbur believed severe childhood abuse precipitated Shirley’s fragmented personality. Sixteen distinct personalities emerged, including a French girl, an artist, a musician, two male selves, a baby, and a teenager called ‘the Blonde’.
The American Psychiatric Association’s DSM-IV (Diagnostic and Statistical Manual, 4th Edition) lists several dissociative disorders. There is not a clear consensus on diagnosis and treatment. In simplified lay terms they include:
- depersonalisation disorder, which presents as periods of detachment and feeling ‘outside of’ one’s self;
- dissociative amnesia, a memory disorder characterised by loss of recall for a time ranging from hours to years;
- dissociative fugue, which results in confusion about identity, usually wandering and unplanned travel, and in some cases assumption of a new identity; and
- dissociative identity disorder, which was previously known as multiple personality disorder, and presents as a switching between two or more definite personalities, generally with incomplete
Edward Norton played an abused altar boy in the movie Primal Fear, adapted from William Diehl’s 1992 novel of the same name. Throughout the suspense-packed story, we’re led to believe Norton’s character is suffering from DID. In a nice twist at the end, we discover what appears to be the truth—that the villain’s presentation of DID was just a ruse.
Exaggeration or fabrication of mental illness is known in medical terms as malingering, and is often done for motives such as financial compensation, avoiding criminal conviction or gaining sympathy.
The law and the community demand that people pay for their crimes. There is also a general acceptance that mentally ill people should receive appropriate treatment. The ‘not guilty by reason of insanity’ plea acknowledges society’s belief that defendants who are mentally incapable of controlling their behaviour should not be punished.
Debates will continue to rage about leniency, sentencing, and treatment of the criminally insane. In the meantime, books and movies delving into the darkest twists of the human psyche will continue to fascinate us.