a couple of hours ago as i stood in my office, alphabetizing folders to be filed, i heard a grunt from just outside the doorway. i was startled because the office had been closed for a couple of hours but then again, its not unheard of for patients to stay late when their doctors are willing to work after-hours. when i looked up at the middle-aged woman who stood there, she grunted again and held up a parking ticket she needed to have validated. at this point i realized that the woman was deaf. i stamped her ticket and as she reached down to put it in her backpack, i noticed a drop of blood hit the floor. when she stood up, i asked her if everything was okay, and it was at this point that she opened her mouth to illustrate that everything was not, in fact, okay at all. the inside of her mouth was literally a bay of blood-- a viscous, hypersanguinated gulf from which emerged the yellowish tops of her remaining lower teeth, dotting the bay like tiny islands. the horrified expression on my face must have amused her because she smiled, her upturned lips permitting a tiny rivulet of blood to emerge from the left corner of her mouth which then trickled down her chin. "are you alright?" i asked again, with more concern than the first time. she read my lips and responded by producing a sheaf of small papers, each of which represented the extraction of a single tooth. my guess is that there were probably about nine or ten papers. "well, good luck," i offered. she smiled again, bravely, but this time her mouth stayed sealed. nonetheless i couldnt help noticing that the inner parts of her lips were now stained a bright red, almost as though her lipstick had worn away around the edges leaving a faint trace of where it had once been applied. man, i thought. fuckin' sucks to be you. when i was certain she'd left the building i stopped alphabetizing my charts and walked to the door. looking out of the window across the hall i saw that it was not raining.