Rivkah Writes…

April 7, 2009

A Hole in My Logic

Filed under: On My Mind — rivkahwrites @ 3:04 am

What do my gums, a diabetic friend, and 16-year old Tanzanian girls have in common?  We all have – or in my case, had – something called a fistula. 

Speaking personally, I’ve always had a kind of sixth sense about language, especially since my professors taught me to deconstruct and demystify just about everything. Nevertheless, when my dentist informed me that the bump on the portion of gum above my front tooth was a fistula, deconstruction was the last thing on my mind. Instead, my thoughts ran more along the lines of: “What the hell’s a fistula? How do I get rid of it?” and of course the ever popular, “How much will it cost?” 

It turned out that the fistula,  a pus-filled boil, had developed above a front tooth on which I’d received root canal treatment. Some of the infection had remained in the root canal with no way to escape – hence the fistula. An oral surgeon cleaned out the area without having to redo the root canal  and that was the end of my problem.

The next time I heard the term, I was visiting family in England and had looked in on an old friend with advanced Diabetes. Given his condition, he had had a tube of sorts surgically inserted into his arm in preparation for possible dialysis. Complaining about the discomfort caused by the device, he referred to it as a “fistula.” I dismissed my perplexity, assuming that by some strange coincidence, tubes in the arm are to UK doctors what bumps on the gum are to their US counterparts.

The term came up yet again in February when I was reading an article in The New York Times* about young women in Tanzania. Pregnant at 16, these girls had lost their babies after prolonged labor which left them with a horrible internal wound called a fistula. The fistula rendered them incontinent and given their constant odor, they were shunned by family and friends. 

The recurrence of “fistula” in a context I found heart-wrenching finally spurred me to do some research. My findings were a perfect illustration of Occam’s razor – one explanation that fit each “fistula” situation: according to WebMD, a fistula is “a passage or hole that has formed between…two organs in your body.”

In other words, a fistula is a hole, and the hole in my logic was assuming it was just a name, when in fact like all words – even some names – it’s a descriptive term with contextual permutations. Which means a fistula is dental when it’s a pus-filled boil on your gum; arteriovenous when it’s a procedure  surgically joining an artery to a vein in preparation for dialysis; and vaginal when it forms in the walls of the vagina.

And the moral of the story is – never underestimate the power of words.


*After a Devastating Birth Injury, Hope. The New York Times, February 23, 2009.


  1. Rivkah,

    Your post left a fistula in my thoughts. How do I cure it?


    Comment by Vincent — July 6, 2009 @ 3:44 pm | Reply

  2. LOL – not quite sure of that one, Vincent, but feel better soon!

    Comment by rivkahwrites — July 6, 2009 @ 6:19 pm | Reply

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