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Radio Transcription
Ep 61: Part 1 of 3 of Dr. Chao's Interview with James Cecchini, D.D.S, PhD and Ernie Follico, D.D.S., M.S.
Salvador Gaytan: It's time! SmileTalk is on the air, featuring the latest news and developments in dentistry as well as other interesting topics that make people smile. I'm Salvador Gaytan, and I'm here with?
Dr. John Chao: Dr. John Chao, we have some interesting guests who will make interesting entertainment also.
Salvador Gaytan: Absolutely, they're definitely going to make the audience smile, isn't that right, Dr. John?
Dr. John Chao: Yes, and with some very interesting music.
Salvador Gaytan: And I want to alert the audience, this is a very -- well, you know we've had guests on before. These are two very fascinating guests. It's going to be very entertaining, as well as there's going to be some information about dentistry of course, about Iatrosedation, which Dr. John, just briefly tell the audience what that means.
Dr. John Chao: Iatrosedation is a special technique that was developed at USC School of Dentistry back in the 70s. It's for calming anxious patients. Iatro means doctor, and sedation means calming. So, the doctor using no pharmaceuticals calms the patient and helps the patient overcome anxieties related to dentistry. So, that's called Iatrosedation.
Salvador Gaytan: And when you say no pharmaceuticals, that means no drugs.
Dr. John Chao: No drugs, no IV sedation, no general anesthesia, no oral sedatives, just basically using clinical techniques, chair side techniques to help the patient overcome whatever caused the problem.
Salvador Gaytan: And like you say, Dr. John, we're going to give the audience some sugar. What's your saying again?
Dr. John Chao: A little bit of sugar makes the medicine go down.
Salvador Gaytan: That's right, that's right. So, that's the entertainment part, and I will say there is a lot of entertaining things that the audience is going to hear.
Dr. John Chao: We're going to talk about how painless this medicine is going to be.
Salvador Gaytan: That's correct, that's correct, because we…
Dr. John Chao: It's a really painless medicine.
Salvador Gaytan: Because people or a lot of cowards out there, chickens that don't want to go to the dentist because of the pain, but this is a pain free way, isn't it?
Dr. John Chao: Yes, and one of our two guests is actually a dentist and a doctor of psychology, a PhD in Clinical Psychology. He's going to talk to us about how we can make dentistry painless for our patients.
Salvador Gaytan: And he has a very, very unusual way that he used to relax his patients, and you're going to want to hear that.
Dr. John Chao: Stay tuned.
Salvador Gaytan: So, stay tuned. So, let's get to introducing our guests. The first guest we have is Dr. Jim Cecchini, he is a general practitioner, and has a PhD in Psychology. How are you doing today Jim?
Dr. Jim Cecchini: I'm pretty good, Sal, how are you?
Salvador Gaytan: Fantastic, fantastic.
Dr. John Chao: Thank you for coming yourself and bringing your friendly guitar.
Dr. Jim Cecchini: Oh well, I'm looking forward to it, yeah.
Dr. John Chao: Yeah, we'll be hearing you play that, aren't we?
Dr. Jim Cecchini: Well, I'll do the best I can.
Salvador Gaytan: And we have our second guest, Dr. Ernie Follico. He was an orthodontist, but still practices today somewhat. How are you doing today, Ernie?
Dr. Ernie Follico: Great, great to be here.
Salvador Gaytan: Just briefly, you were an orthodontist, and you're retired now, but you still practice a little bit, don't you?
Dr. Ernie Follico: Yes, I cover for orthodontists when they take vacations. I have a few friends that I do that for. So, I keep my hand in, keeps it interesting, and I love doing that.
Salvador Gaytan: And just to let the audience know, the connection between these two gentlemen, Dr. John has known these gentlemen for a long time, but also Dr. Follico and Dr. Cecchini have known each other, believe it or not, since kindergarten.
Dr. Jim Cecchini: That's right.
Salvador Gaytan: That's true.
Dr. John Chao: That was from World War I, was it?
[Laughter]
Dr. Jim Cecchini: There was some war going on, I don't remember which one it was.
Dr. John Chao: Actually you guys are not that many years older than me.
Salvador Gaytan: Are you trying to juice up our guest, Dr. John?
Dr. John Chao: They look great.
Salvador Gaytan: They look fantastic, they're in excellent condition. So, let's get to just a little bit of background, Dr. John, to kind of bring us into how you met these gentlemen, and let's start there.
Dr. John Chao: Well, actually I met both Dr. Follico and Dr. Cecchini back in the, I think, early 70s. I started the tradition -- maybe earlier than that. I started this tradition, at the time, of having TGIFs -- you know what TGIF stands for?
Salvador Gaytan: Thank God it's Friday.
Dr. John Chao: Yeah. And we have one TGIF party once a month, but at different offices. So, everybody get together on a selected Friday for the month, and we get together, and we have fun and music, and it was a great time, wonderful, wonderful time. And we get to meet all the fun dentists in the area who like to socialize, and one of the most sociable dentists was Dr. Cecchini, and Dr. Follico.
Salvador Gaytan: Now, you were in what city? You were in…?
Dr. John Chao: I was in Monterey Park at the time, and Dr. Follico and Dr. Cecchini were practicing together in the same building that they built on Beverley Boulevard in Montebello. And so, that was my earliest memory of the two dentists, and basically having a good time.
Salvador Gaytan: Good time, fantastic. So, you were having killer parties once a month?
[Laughter]
Dr. John Chao: Killer parties, I don't know how killing they were, but we had some fun.
Salvador Gaytan: These aren't x-rated parties, right?
Dr. John Chao: No, no.
Dr. Ernie Follico: Maybe he was a Chinese answer to Hugh Hefner. He gave great parties, great parties.
Dr. John Chao: Well, actually more like Don Ho.
[Laughter]
Salvador Gaytan: So, that's how Dr. John met them. Now, Dr. Cecchini and Dr. Follico, why don't you just describe for us a little bit, you met in kindergarten, is that right?
Dr. Jim Cecchini: Yeah, he was in kindergarten, but we never really had classes together in the first six grades. We jumped around, but we weren't in class, so there was no long-term connection, but we seemed to just enjoy each other's company.
Dr. John Chao: Dr. Follico said that there was a little problem in the beginning. He couldn't play baseball like you did.
Dr. Jim Cecchini: Yeah, well, he was a terrible outfielder, he was making all the errors and I wanted to win the games, and he was the last one to choose. And I'd say, "Okay, I'll take this guy over here, and put him out in the right field."
But the ball seeks its weakest link in baseball, so when the chips are down, bases loaded, and they need a winning run, certainly the next time I pitched the ball, it's going to be hit to Follico. And I'll never forget one time it went through his legs and all four runs scored. And I don't think I spoke to you for about a week after that.
Dr. John Chao: Well, Ernie, you're sitting over there laughing and grimacing, would you tell us your version of this?
Dr. Ernie Follico: Well, it's mostly true. I was the last guy chosen for the baseball team, so I just never had an affinity for baseball, and Jim was an exceptionally good player, even when we were young kids. So, I was nervous as could be, no matter what position I was playing, but when I was in the outfield, like he said, and those fly balls came to me, I couldn't judge them. So, I cost us some games over the years.
Salvador Gaytan: And for anyone just tuning in, you're listening to SmileTalk with Dr. John Chao, spelled C-H-A-O. I'm Salvador Gaytan, and anyone that wants to get in contact with Dr. John, you can go to AlhambraDental.com or 626-308-9104.
We have our two fascinating guests, Dr. Ernie Follico, and Dr. Jim Cecchini. We're going to be talking about Iatrosedation, which is painless medication. But right now we're just talking about kind of the history of how you became to know these two gentlemen, and how they knew each other. But what kindergarten and what city was this that you were talking about?
Dr. Jim Cecchini: That was in East LA, Fourth Street Grammar School.
Salvador Gaytan: Fourth Street Grammar School, okay, is this still there?
Dr. Jim Cecchini: It's still there, yes, it's still there.
Salvador Gaytan: Fantastic.
Dr. Ernie Follico: Then we went onto the junior high together and high school, in Curran Junior High, and at Garfield High School.
Dr. Jim Cecchini: That was in East LA.
Dr. John Chao: So, you're a couple of local boys.
Salvador Gaytan: Local boys.
Dr. Jim Cecchini: Yes, that's right.
Dr. John Chao: Just an insight about Dr. Follico; he is and was a fabulous orthodontist. You know, but general practitioners, we are good at taking a cavity and filling it. That's why I don't like to play golf too much, because I'm filling holes all day.
Salvador Gaytan: That's right, but Dr. John is a good player of {golf}.
Dr. John Chao: But I just realized that Dr. Follico couldn't catch a ball, he doesn't have the eye-hand coordination to catch a ball, maybe that's why he never became a general dentist.
Dr. Ernie Follico: Didn't try the same with the drill.
Dr. John Chao: He had escaped to the specialty and became an orthodontist, he doesn't have to play with cavities, isn't that right?
Dr. Ernie Follico: Exactly, yeah, a good analogy.
Dr. John Chao: So, people who can't fill cavities, they became orthodontists.
Dr. Jim Cecchini: Yes, that's the compensation theory.
Dr. John Chao: The compensation theory that's coming from your psychological background.
Dr. Jim Cecchini: Yes, that's the {Artillerian} compensation theory.
Dr. John Chao: Okay, we'll get to that later.
Salvador Gaytan: Well, Dr. John, let's get to our dental topic, which is very fascinating, which is Iatrosedation, and take it away, Dr. John.
Dr. John Chao: Well, Iatrosedation is a program that was started at USC, and Dr. Cecchini was very involved with the starting and the executing of that program, that has treated thousands upon thousands of anxious patients at the school.
And that's the technique that I also learned when I was there. So, Dr. Cecchini, would you tell us how that came about? What does Iatrosedation really mean, and why was it necessary?
Dr. Jim Cecchini: Iatrosedation is a combination of two words. You take Iatro and sedation, Iatro meaning doctor and sedation meaning calming. So, you put them two together, it means the act of calming through the doctor's behaviors.
So, there's a fellow by the name of Nate Friedman, the late Dr. Nate Friedman. He was the developer of this technique, and he spent most of his life trying to help these pour souls out there that are very anxious about dentistry.
So, he developed this term, Iatrosedation. He designed it with the model of trust involved in it. And he always used to say that fear is soluble in trust. If you can find somebody that you can really trust, that fear seems to fade away.
So, with that in mind, he did some research, and he came up with this model of trust that is incorporated in the whole Iatrosedative process. And that involves several steps in the interviewing phase, where the doctor gives the patient a feeling that there is a willingness to help the patient. So, there is some care and concern involved.
Dr. John Chao: So, if a patient is anxious, and goes to the doctor, how does trust melt away the fear?
Dr. Jim Cecchini: How does trust melt away the fear? Well, a lot of it has to do with several things. So, one is, like I say, the acknowledgement of the fear says to the patient that, "Hey, he's interested in helping me, okay?"
Another aspect is, the doctor has to show the patient some levels of expertise, and that is done through use of questions, through active listening, listening to the patient, gathering information that is pertinent to design and a treatment modality, specifically for that, which the patient is fearful of.
Dr. John Chao: So, let's say I'm a patient, who is very, very scared, and I came to USC or I came to you, and I'm just trembling in my chair. Now, what do you do to start with? What is the first step, what do you say to me?
Dr. Jim Cecchini: Well, the first thing I want to do is acknowledge the fear, and there's many ways of doing that. If you come in and let's say I don't have anything on the chart that indicates that you're anxious about dentistry, non-verbally there are so many ways to find out anxiety, as you will know, John. So, I would say in a soft sharing way, "I'm sensing that you're anxious about something. Can you tell me something about that?"
Dr. John Chao: Now, when you shake my hand, doesn't that…
Dr. Jim Cecchini: Cold and clam.
Dr. John Chao: [Crosstalk] patient, clammy, kind of wet hands is one sure sign.
Dr. Jim Cecchini: That's one clue, absolutely.
Dr. John Chao: What other signs can you physically detect, eye strain or…?
Dr. Jim Cecchini: Yeah, shaking, cold and clamminess, maybe poor eye contact, wanting to go to the bathroom a lot, general tension of the body, okay. These are some clinical, obvious clinical signs that you can tell of anxiety. So, I would address that, "Can you tell me, is there something about dentistry that bothers you?"
Many times they will address it, sometimes they are confused, they are nebulous, they're not quite sure, and that has to be because of different ways people learn to fear.
Dr. John Chao: So, in other words you're saying to the patient, "Listen, if you are scared, it's perfectly okay with me," acknowledging the fact that that's something you're quite open and willing to deal with, so you're going to actually bring it out and talk about it, because you have the confidence. You recognized the problem, and you're going to deal with it.
In my office, I'll make a joke out of it, sometimes I'll say -- I know this patient is having problems with dentistry. I walk in, I say "You know, I am a specialist in dealing with phobia. In fact, I'm a chickenologist. I deal with chickens." I say, "I love cowards."
Sometimes you'll say, "Well, gee, I am not really a coward," I say, "No problem, I'll still treat you like one. You won't object to that, would you?" So, we're kind of making a joke out of it, but in making the joke, I'm basically saying it's okay for you to be there where you are, and I'm perfectly confident that I can take care of it. And that's the trust that we're talking about, right?
Dr. Jim Cecchini: Yeah, the use of humor is really good with any kind of patients, but especially anxious patients.
Dr. John Chao: And the use of music.
Salvador Gaytan: Music.
Dr. Jim Cecchini: Yes, absolutely.
Salvador Gaytan: Well, now that we come to the part that I promised, that very fascinating way of dealing with patients who are chickens, have anxieties. Now, Dr. Cecchini, in your practice -- now, you don't practice anymore right now.
Dr. Jim Cecchini: No, I don't.
Salvador Gaytan: But when you were in your heyday practicing, this is what, the 70s, 80s, correct?
Dr. Jim Cecchini: Yes, also in the 60s.
Salvador Gaytan: In the 60s, okay, 60s, 70s, 80s. If you had an anxious patient, what were the two things that you used to offer them?
Dr. John Chao: They're anxious.
Dr. Jim Cecchini: Sal, I didn't do this with all patients, but I would offer them a little glass of wine. If the dentistry was over, I'd give them a little sip of wine. And in some ways, it's a carryover to the next time. They see me as a downright guy, who wants to have good times with the patient, and by the way he didn't hurt me any way.
Dr. John Chao: So, I just want to clarify this. You gave them a glass of wine, it's not like you have a glass of wine too, right? You just sit there and watch them have the glass of wine. I don't see you doing that, Jim.
Dr. Jim Cecchini: Sal, sometimes I do. John, yes I do, at the end of the day I would do something like that, there's no question about that. So, I find that music moves a lot of people.
Salvador Gaytan: So, some patients you would offer a glass of wine, and you would play them a song on your ukulele?
Dr. Jim Cecchini: Yes, I started with the ukulele, this is back in early 60s, and the reason why I got all fired up with music is that I had a dental assistant that had a boyfriend that came in with a guitar. And all he could do is sing three Tom Dooley songs on the guitar, but they were great, and I could see the patients rising to the occasion. I said, "I've got to do something about that."
Dr. John Chao: Tom Dooley, maybe for audience who hasn't heard this song, can you play a few bars from that? Can you sing a few bars?
Dr. Jim Cecchini: Okay, I knew I was coming here.
Dr. John Chao: And "Hang down your head Tom Dooley" right, definitely [crosstalk].
Dr. Jim Cecchini: Yes.
Salvador Gaytan: Well, I mean would you actually just play music for your patients or would you sing to them as well?
Dr. Jim Cecchini: I would try to sing. I'm not a good singer, but I got them as a captive audience [crosstalk].
Salvador Gaytan: So, you took the gamble that you may not see that patient again?
[Laughter]
Dr. Jim Cecchini: Yes, but they liked the courage. I think they liked the courage.
Dr. John Chao: That wasn't a form of torture.
Dr. Jim Cecchini: But anyway, I thought I'd write a song for this occasion.
Dr. John Chao: Okay, forget Tom Dooley, we want to hear the song that you wrote.
Dr. Jim Cecchini: Okay, you want to hear it?
Salvador Gaytan: Fire away.
Dr. John Chao: Yes, absolutely, yes.
Dr. Jim Cecchini: "Well, I went to the dentist the other day, as scared as I could be. Tools and drills and instruments don't get along with me." I'm getting there now.
"Well, I said to the dentist, the dear little dentist, take me out of here. I'm scared to death and beginning to cry, and my eyes are filled with tears. I said Johnny, Johnny, shame on you, I don't know what to say. The dentist is here to help you find a dental decay."
"Well, I'm glad I saw a dentist, he saved a tooth or two. He's my friend for life, and I hope that he is yours too."
[Applause]
Salvador Gaytan: Alright, very good.
Dr. John Chao: Alright.
Dr. Ernie Follico: Pretty good.
Dr. John Chao: That's Dr. Jim Cecchini. This is great. Now, this is a song composed by you. Was it just in couple of days, right? Because you were invited to come on the show, so you composed this song just for this show?
Dr. Jim Cecchini: Right.
Dr. John Chao: That's great.
Salvador Gaytan: Now, I want to tell our audience, we don't want you going to your dentist and saying, "Hey, can you give me a glass of wine and play the guitar for me, because that's going to relax me," because they're probably going to say, "What?"
[Laughter]
And unfortunately Dr. Jim Cecchini is not practicing anymore, but maybe the fans might bring you out of retirement for a day a week?
Dr. Jim Cecchini: Oh God, I don't think so. I'd rather just play up in a bar, and get out my jazz guitar, and have a few shots headed that way.
Salvador Gaytan: And now let me just ask you one follow-up question. In fact I'm going to call you Dr. Jim and Dr. Ernie from now on, because I call him Dr. John. So Dr. Jim, what was the reaction that your patients had when you did this for them?
Dr. Jim Cecchini: It's a great distraction, number one.
Salvador Gaytan: And did you ever do it before procedures to relax them or was it always after?
Dr. Jim Cecchini: It's before, during and after, okay? Sal, I remember a patient like that. I had a banjo, and I had just taken out all her upper teeth and put an immediate denture in, John. And put some cotton rolls in her mouth, and I whipped out this Banjo and I played "Five Foot Two Eyes of Blue" for her.
Dr. John Chao: Now, that's a Charleston, isn’t it?
Dr. Jim Cecchini: Well, it's kind of like one.
Dr. John Chao: Actually, just so the audience can know what kind of dance this is, you kind of kick your right leg up, and you move with one of the Follies and so on.
Dr. Jim Cecchini: Yes, you can. It's 20s, 30s, "Five foot two, eyes of blue, oh what those five foot do", and she get up out of the chair and she'd do a little Charleston gig, you know. And that moment was a magic moment for me, because it made me realize how much of a distraction music can be, especially under a traumatic experience like this here.
So, a distraction -- my son is a dentist now, and he used to see his dad do all of this, and he says, "God, I got to get a distraction of some sort." So, one day I looked down the hall, and I looked at him, and there he was. He had coins, he was doing magic coin act for somebody.
And it doesn't have to be coins, it doesn't have to be a guitar or anything, but somebody having some distraction technique can be advantageous to anxious patients.
Dr. John Chao: Yeah, I know how that works, because I don't know how to play guitar at all. I play a little piano, but I have learned a few coin tricks, so I entertain the kids with it. We make it disappear, go through the hands, go through the ears, and so I know how that is. But what you did for that lady, that's really -- it's more than a distraction, it's kind of like a medicine, and make them [crosstalk].
Dr. Jim Cecchini: Well, she likes to come back, well, she likes to come back. She identifies the dentist not with a negative. She identifies it with the positive.
Dr. John Chao: Well, the fact that she can get up and dance with your music, shows me that she trusts you already. She had a wonderful rapport with you, and she expected that doing the dance is perfectly okay with you.
Dr. Jim Cecchini: Absolutely.
Dr. John Chao: You're not a straight-laced stiff-faced dentist who would be totally shocked with that.
Dr. Jim Cecchini: Absolutely, absolutely.
Salvador Gaytan: Now, Dr. Jim, did you ever have a patient roll their eyes and go, "What's this guy doing?"
Dr. Jim Cecchini: Oh, I've had them say, "I don't want any music from you." A few, just a few, but most in the main…
Dr. John Chao: Are they people who have heard you before or it was just first time?
Dr. Jim Cecchini: Well, I don't remember, I think they're brand new. "No, I don't want it. Get it out of here," that sort of thing. But in the main, they are curious.
Salvador Gaytan: What do they say, "Give me a double wine and hold the music?"
Dr. Jim Cecchini: I would do that, yeah.
Dr. John Chao: Well, Dr. Follico, you're sitting there kind of quiet, what do you do? You offer them wine? Well, what do you do to relax your patients?
Dr. Ernie Follico: Well, no, I had mostly young kids as patients, but my distraction was that I was very animated, and I had a lot of fun with them. And I'd go out in the waiting room and grab a parent and bring them in and say, "Look at how Johnny's teeth are coming along here. We want your part in this, we want your cooperation to help bring the treatment along."
Dr. John Chao: Yeah, I feel picked on today, everybody using John, Johnny.
Salvador Gaytan: Well, that's a common name, huh? That's a common name. Now, Dr. Follico, you actually specialize in orthodontics. So, that's why you say that most of your patients are children or were children. And we're coming to the last few seconds of our show here, but we'd like to carry these two interesting guests to our next show. Isn't that right, Dr. John?
Dr. John Chao: That'll be great. Can you guys come back?
Dr. Ernie Follico: Certainly.
Dr. Jim Cecchini: You bet.
Dr. John Chao: Good, wonderful.
Salvador Gaytan: So, just to wrap up our last few seconds. In fact, we'll get to that on our next show. But our next show, I want you to tell the audience, Dr. Follico, how you dealt with the children, and your distraction techniques, and maybe the ways that you used the Iatrosedation methods.
And there's a lot of other interesting stories that you're going to want to stay tuned for. So, we're coming to the last few seconds. This has been SmileTalk, and if you want to reach Dr. John Chao, spelled C-H-A-O, you can go to AlhambraDental.com or 626-308-9104. And he welcomes all questions, isn't that right, Dr. John?
Dr. John Chao: That's right. Feel free to contact me, see you guys next week.
Salvador Gaytan: Next week.
Dr. Ernie Follico: Great.
[END OF AUDIO]
Transcribed and proofread by:
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