I am often struck by how good a smile feels. Connection, warmth, a little lift to my spirits. Who started this exchange? Did I smile first or volley it back in response?
I'm a natural smiler. The corners of my mouth turn up easily and often. This means I may not be the best bearer of bad news or grave pronouncements. Imagine the biblical prophets raining down judgment and foretelling a grim future with a smile. Their words would float away like butterflies.
So where is a smile exactly what's needed? Mostly everywhere but particularly where there is an imbalance in the relationship. Hospitals are acute care experiences. Patients enter with a problem to be fixed, a crisis to be managed. They entrust their lives mostly to strangers
Few of us have escaped the need to go to the hospital and many of us are grateful for the topnotch care. No doubt, however, we’ve witnessed this imbalance in the relationship between patient and medical care providers. Many years ago my mother-in-law spent four months in intensive care after a car accident. A few years ago my mother made several trips to the oncology floor. Recently my husband Duncan received care in a renowned medical center. Every time we were so grateful for a smile, a kind word.
But first a bit of background. Fifteen years living with Parkinson’s disease, Duncan determined that medicine had taken him as far he could go. Deep brain stimulation surgery was the next treatment option. It is not completely understood why a probe in the brain emitting electrical signals blocks the abnormal activity of tremor, rigidity, cramping. But it does.
My methodical, inquisitive partner prepared with vigor. He read every available medical journal article, considered potential adverse events, researched the efficacy of the stimulators available (how did they work? what was the company's stock performance?), picked the neurosurgeon with most experience, and quizzed the medical team thoroughly. He was ready and when a cancellation moved up the surgical date to Thanksgiving week, our daughters booked flights to be with us and our extended family stood ready.
What I don't think either of us fully anticipated is how vulnerable Duncan would be or the toll it would take. And how grateful I felt when smiles came our way. It’s hard to predict how dependent you are in a hospital for information, competence, kindness. A patient loses agency – the freedom to act alone. Yes, he kept asking questions during the surgery – awake, curious, following directions to move his hand this way and that. And, make no mistake, the doctors were compassionate. The pre-op and post-op nurses were communicative.
Nevertheless, a hospital is a deeply disorienting place. And this is where smiles make a true difference. Nurses and patient techs are the backbone of patient care. Many recognize the humanity of their work.
It only takes a smile to bestow personhood on a patient. You are more than a checklist.
It only takes a smile to welcome the caregiver’s questions and acknowledge this is hard.