Smile though your heart is aching, Smile even though its breaking
When there are clouds in the sky, you’ll get by
If you smile through your fear and sorrow, Smile and maybe tomorrow
You’ll see the sun shining through for you”Lyrics by john turner and geoffrey parsons (recorded by nat king cole)
Monday afternoon my plasma exchange treatment went long due to a machine failure so I decided I would suck it up and take transit home assuming surface routes would be gridlocked at rush hour in downtown Toronto. As I walked under the hospital towards the subway station I was stopped in the corridor by a young man who seemed genuinely happy to see me. It took a minute for it to sink in, but he was an intern I had dealt with at some point over the past year or so though I could not remember his name. He said to me “It’s great to see you walking about!” I smiled broadly back at him and let him know that I was getting a little better every day and growing stronger. He said he was so glad and laughing a little shook his head and said, “You always have that smile no matter what your situation!”
To say that I always smile would be an exaggeration. However, it is a habit and as it turns out it has been a very beneficial one to have! I can tell you for sure I was not always a happy person, and through my early years was full of surly attitude; back then, a smile might well have proven a vulnerable chink in my armor. Over the years, however, I’ve found a disarming smile far stronger than a suit of armor.
Smiling may not come naturally, but you can learn to smile more by practicing, just like any other habit. Upon reflection, I believe I can trace my smiling habit back to some sales training I received as a young person with a part-time telemarketing job. When “cold-calling” I was reminded to smile when I spoke to customers on the telephone as it comes through as friendliness in your voice. I am by nature a shy person, but I learned that putting on a smile helped me seem more confident, like putting on a well-tailored suit. This is a habit that served me well as a sales professional both on the telephone and in-person. While I could hardly be considered a beautiful woman, I recognized that a warm smile put people at ease and made them more likely to smile back and establish an early connection with them.
Scientists tell us that smiling releases dopamine, endorphins and serotonin in the brain – these are ‘feel good’ neuropeptides that relieve stress and pain as well as lifting your mood. (Stevenson, S., “There’s Magic in Your Smile” June 25, 2012, http://www.PsychologyToday.com). Thus smiling provides benefits not only to your attitude but your overall health as well.
I also noticed early that when you smile at people, even complete strangers, they tend to smile back… It is said that smiles, like yawns, are contagious! You can experiment with this, preferably during a brief encounter that won’t put you in an uncomfortable position, for example when passing someone going the opposite way on an escalator. Now you are lifting not only your mood but the moods of others as well!
When I was a teenager, my grandmother was diagnosed with cancer. Upon registration at the hospital she lied about her age, shaving a few years off to put her under 60. Why would she do this? She believed that the doctors would try harder to save someone who was younger! Our family has always shared a good laugh about this strategy. I personally do not believe that any healthcare professional would consciously feel that way, but if you are of this mind also, consider smiling more… Mark Stibich PhD, suggests that smiling makes us seem younger and more attractive to others (Stibich, M. “Top 10 Reasons You Should Smile Every Day” December 1, 2018, http://www.verywellmind.com). It would be irresponsible to suggest that your doctors will try harder to save your life if you smile at them, but you may find people in general are willing to spend a little more time with someone whom they feel attracted to or comfortable around rather than someone who is sour-faced and bitter.
Likewise, healthcare professionals would be well-advised to smile more at their patients. I will never forget an encounter I had with a doctor at the hospital when my kidneys failed. He was new to me, I don’t recall his name but let’s call him Dr. No. When Dr. No spoke he never smiled or looked me in the eyes. I had just begun dialysis and was thinking about the future. I posed the question to him, “With scleroderma renal failure I understand that there is some hope of kidney recovery, do you think there would be any chance of coming off of dialysis at some point in the future?” I was sitting in bed at the time and the listening Dr. No stared so far over my head I felt I could see right up his nose… with a blank expression and gazing at what appeared to be a moving object towards the ceiling he said, “If you hope to have a better quality of life then you would consider a kidney transplant,” and with that he walked out the room. I felt quite cold and despondent when as he left me there. I longed for my amazing, caring doctor to had helped me to remain so positive thus far.
When I subsequently complained about this encounter to my husband, I needed to be reminded that perhaps this doctor had some sort of social anxiety and could not help it that he failed to connect with me. Dr. No reminds me a little bit of the television character, Dr. Murphy on the popular series, The Good Doctor. It is about a surgical intern on the autism spectrum who, while brilliant, struggles to socially connect with patients and hospital staff. Perhaps a part of a doctor’s training should be to practice a kind, empathetic smile to reduce stress on a patient when delivering information, given the science of smiling (whether a genuine or rehearsed smile) it should, theoretically, put both doctor and patient at greater ease.
Gradually, scleroderma has been stealing my smile. Chronic fatigue and pain can make it difficult to maintain a sunny disposition and a smiling countenance. More than that however, the skin tightening in my face has made it harder to open my mouth (microstomia), reducing the size of my smile. In addition, my lips are thinning, such that they almost disappear when smiling. The only treatment for microstomia that I am aware of is mouth stretching exercises, interestingly enough, many of these involve ‘smiling’ exercises. Scleroderma and Raynaud’s UK recommends doing mouth stretching exercises twice a day. (I do find it hard to remember to do my exercises so I put the sheets in a plastic sleeve on the counter where I brush my teeth to serve as a reminder.)
When I think about the deterioration of my smile, it makes me self-conscious. I particularly avoid photographs. But, nothing feels better than smiling or laughing — even if it is my own jokes which I am known for laughing at harder then anybody else in the room. Because of this I tend to like being around fun people, watching up-beat comedies and positive programming on TV and online, or posting funny tidbits on social media (look for Sick with Optimism on Twitter @OptimismSick and Facebook @SickwithOptimism).
I don’t want to lose my smile, so my marching orders now are to not only work on my microstomia exercises but to also smile more at the people I see the most, my family. It is unfortunate that so often our family sees us at at our worst: tired and grumpy in the mornings and evenings. I am writing myself a prescription today to smile at each one of them, at least twice a day, and hopefully much more. I just tried it with my daughter, and we both ended up giggling for no apparent reason, at which point (seriously) I felt a warm glow wash over me. Yes, it is likely my family will think I’ve taken leave of my senses, but if my smiling can make them smile back, it will be worth it!