Risorius: the power of a smile 

I’m fascinated by reflexes. A simple tap on a knee tendon triggers a complex neural cascade, resulting in a swift, involuntary muscle contraction. Recently, I’ve been captivated by another reflex: the smile. My appreciation of it came with the recent arrival of our grandson. Seeing his face, sensing his presence, induces a smile so automatic, so deep, that I can almost feel the pathways and sense the bridging of synapses. It’s a visceral reaction, a neuromuscular process forged through deeply personal interactions.

While smiles can be voluntary or reflexive, they are all a complex interplay of muscles, nerves, and emotions culminating in the familiar curve of the lips. This facial expression, seemingly simple, can convey a myriad of feelings, from joy and contentment to empathy and compassion.

So, what’s the relationship between the experience of a smile and the practice of medicine?

Connection to other human beings.

A smile can say, “I know you’re in pain, but I see you, and I’m here for you.” Frequently, in that moment of connection, our smile is mirrored on the faces of our patients.

Even before COVID, those smiles were often hidden beneath protective masks. But the pandemic exacerbated that loss, hiding our faces beneath layers of protection, minimizing exposure to pathogens, while at the same time insulating us from needed connection. Often, I’ve wanted to invent a “mood mask,” analogous to the mood rings of the 70s, that could change hue parallelling the emotion beneath. In that way, our visual expression of emotion can be conveyed.

Smiling, a simple yet powerful gesture, can significantly enhance the patient’s experience. A genuine smile can convey empathy, warmth, and reassurance, fostering a positive and trusting patient-clinician relationship. By consciously smiling during interactions, healthcare professionals can create a more welcoming and comforting atmosphere.

To maximize the impact, try mindful smiling. This involves smiling with sincerity and authenticity, rather than a forced or artificial expression. By focusing on positive thoughts and emotions, clinicians can evoke genuine smiles that resonate with patients.

By prioritizing smiling and empathetic communication, healthcare professionals can elevate the patient’s experience and contribute to overall well-being.

Risorius: a narrow band of muscle fibers arising from the fascia over the masseter muscle, inserted into the tissues at the corner of the mouth, and acting to retract the angle of the mouth. This is how we smile! 

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.