“Ten years ago, my smile walked off my face, and wandered out in the world. This is the story of my asking it to come back.”
Sarah Ruhl is a lauded New York City playwright (Eurydice et al.). These warm and beautifully observed autobiographical essays stem from the birth of her twins and the slow-burning medical crises that followed. Shortly after the delivery, she developed Bell’s palsy, a partial paralysis of the face that usually resolves itself within six months but in rare cases doesn’t go away, and later discovered that she had celiac disease and Hashimoto’s disease, two autoimmune disorders. Having a lopsided face, grimacing and squinting when she tried to show expression on her paralyzed side – she knew this was a minor problem in the grand scheme of things, yet it provoked thorny questions about to what extent the body equates to our identity:
Can one experience joy when one cannot express joy on one’s face? Does the smile itself create the happiness? Or does happiness create the smile?
Women are accustomed to men cajoling them into a smile, but now she couldn’t comply even had she wanted to. Ruhl looks into the psychology and neurology of facial expressions, such as the Duchenne smile, but keeps coming back to her own experience: marriage to Tony, a child psychiatrist; mothering Anna and twins William and Hope; teaching and writing and putting on plays; and seeking alternative as well as traditional treatments (acupuncture and Buddhist meditation versus physical therapy; she rejected Botox and experimental surgery) for the Bell’s palsy. By the end of the book she’s achieved about a 70% recovery, but it did take a decade. “A woman slowly gets better. What kind of story is that?” she wryly asks. The answer is: a realistic one. We’re all too cynical these days to believe in miracle cures. But a story of graceful persistence, of setbacks alternating with advances? That’s relatable.
The playwright’s skills are abundantly evident here: strong dialogue and scenes; a clear sense of time, such that flashbacks to earlier life, including childhood, are interlaced naturally; a mixture of exposition and forceful one-liners. She is also brave to include lots of black-and-white family photographs that illustrate the before and after. While reading I often thought of Lucy Grealy’s Autobiography of a Face and Terri Tate’s A Crooked Smile, which are both about life with facial deformity after cancer surgery. I’d also recommend this to readers of Flesh & Blood by N. West Moss, one of my 2021 favourites, and Anne Lamott’s essays on facing everyday life with wit and spiritual wisdom.
More lines I loved:
imperfection is a portal. Whereas perfection and symmetry create distance. Our culture values perfect pictures of ourselves, mirage, over and above authentic connection. But we meet one another through the imperfect particular of our bodies.
Lucky the laugh lines and the smile lines especially: they signify mobility, duration, and joy.
With thanks to Bodley Head for the free copy for review.
Just over a year ago, I reviewed Dr Gavin Francis’s Intensive Care, his record of the first 10 months of Covid-19, especially as it affected his work as a GP in Scotland. It ended up on my Best of 2021 list and is still the book I point people to for reflections on the pandemic. Recovery serves as a natural sequel: for those contracting Covid, as well as those who have had it before and may be suffering the effects of the long form, the focus will now be on healing as much as it is on preventing the spread of the virus. This lovely little book spins personal and general histories of convalescence, and expresses the hope that our collective brush with death will make us all more determined to treasure our life and wellbeing.
Francis remembers times of recovery in his own life: after meningitis at age 10, falling off his bike at 12, and a sinus surgery during his first year of medical practice. Refuting received wisdom about scammers taking advantage of sickness benefits (government data show only 1.7% of claims are fraudulent), he affirms the importance of a social safety net that allows necessary recovery time. Convalescence is subjective, he notes; it takes as long as it takes, and patients should listen to their bodies and not push too hard out of frustration or boredom.
Traditionally, travel, rest and time in nature have been non-medical recommendations for convalescents, and Francis believes they still hold great value – not least for the positive mental state they promote. He might also employ “social prescribing,” directing his patients to join a club, see a counsellor, get good nutrition or adopt a pet. A recovery period can be as difficult for carers as for patients, he acknowledges, and most of us will spend time as both.
I read this in December while staying with my convalescent mother, and could see how much of its practical advice applied to her – “Plan rests regularly throughout the day,” “Use aids to avoid bending and reaching,” “Set achievable goals.” If only everyone being discharged from hospital could be issued with a copy – pocket-sized and only just over 100 pages, it would be a perfect companion through any recovery period. I’d especially recommend this to readers of Maggie O’Farrell’s I Am, I Am, I Am and Christie Watson’s The Language of Kindness.
At one level, convalescence has something in common with dying in that it forces us to engage with our limitations, the fragile nature of our existence. Why not, then, live fully while we can?
If we can take any gifts or wisdom from the experience of illness, surely it’s this: to deepen our appreciation of health … in the knowledge that it can so easily be taken away.
Published by Profile Books/Wellcome Collection today, 13 January. My thanks to the publisher for the free copy for review.