Whenever I look at old photos of my mother, all I see is the big toothy grin on her face. She always lit up a room and was eager to engage with others. She loved participating in the neighborhood squirt gun battles (she was a kid at heart) and loved showing my friends her injured middle finger in a splint.
She always led with a smile, and yes, in retrospect, my mother was quite a cut-up, but she was genuine in her role as a citizen—caring for and caring about others. She insisted that my brother and I felt the same way about our roles in society. We were to understand the trials and tribulations of others and be ready to assist as needed. She didn’t call it empathy, but it was empathy in spades.
While the smile was genuine, the woman behind the smile suffered some significant issues at times. Growing up in a family with close-to-the chest emotional expression and nurturing, engaging in a marriage rife with verbal abuse and alcoholism, being a single parent for two teenagers, and enduring significant pain from a childhood accident, I now know that the smile at times was a façade for a troubled woman trying to strike out on her own and be the best parent that she could be.
She smiled and engaged with others, often to excess. She was valued as a dear friend and a trusted resource in the community. My friends loved her and always enjoyed their interactions with her. But did we see beyond or behind the smile? We did not.
So, was the smile just a façade or was it a true measure of her love for others? I think it was both, more of the latter. But like so many things in life, it was complicated.
I have always emphasized the need (to myself) to smile as often as appropriate in my medical interactions, family interactions and social interactions. One of the five lessons in my career has been to smile and engage.1 Perhaps that has been a skill ingrained from an early age from my mother, but I certainly found it to be a meaningful way to gain trust as part of the clinical process.
My job was to provide the best care possible. And I needed to do it in a manner that instilled trust and engendered a common humanity. A smile does that. A smile lets those in my care know that I am there with them and willing to share in their journey. A smile lets them know that I am engaged (present, attentive, attuned and responsive) and am a co-partner on this journey. A smile is crucial to responsive communication. A smile can say so much – I hear you; I want to help; I understand; How can I help. A smile is not being dismissive but rather demonstrates a willingness to share and be helpful. It acknowledges that I see you (like that smile in the grocery store or on the sidewalk) and that you are worthy of my attention.
In the Broadway musical ANNIE, the number “You’re never fully dressed without a smile” refers to a commercial for toothpaste, but I have internalized the message to mean I should consider a smile as much a part of my demeanor as courtesy and civility.2
In the discussion above, I have emphasized “giving” a smile – that is, leading with a smile to demonstrate one’s caring nature and acceptance of others. Is “giving” a smile different from “receiving” a smile? When considering how to receive a smile, I think that there are several considerations –
- Acknowledge the smile with a return smile or similar gesture that signals that you have received their gift and you appreciate it. This form of Catch! demonstrates that something was passed your way, that you received it, and that you are passing something back.3
- Consider the receipt of the smile as a strong indication that you are now ready to appreciate this interaction as a valued one. Even that smile in the grocery store parking lot can be very meaningful on a stressful day.
- Remember that a smile can be a façade and covering up emotional conflict or troubles. Since we never really know what issues others are facing, don’t let a smile, given and received, be an acceptable way for understanding the lives of others. Such an understanding can be superficial. In the example of my mother above, her smile sometimes precluded her from really sharing her turmoil with others and, likewise, her smile precluded others from understanding that she might be deeply troubled. I also found such examples abundant in my medical career. A smile, given and received, often opened the door to more fruitful exchanges that really got to the root of the encounter and the need for help.
One thing should be emphasized. Some birth defects of the face, neurologic conditions in childhood or adulthood, or dental problems can be a significant impediment to a full smile. People with such adversity should not be judged to not be “fully dressed without a smile.” They can express themselves in other acceptable ways to engage with others, and we should be ready to receive those expressions in a sincere manner.
The pandemic and the need for masking taught me that smile is more than just a toothy grin. Even a masked lower face can express enough emotion to make meaningful contact with others. It requires effort but that is the point. Meaningful interactions require effort, giving and receiving.
Smiles can be contagious. They can lead to consequential interactions as we share our common humanity. Yet, let’s never forgot that our common humanity should lead with empathy and our willingness to really get within (‘em’ – within) the suffering (‘pathos’ – suffering) of others. Give smiles. Receive smiles. And do it with care and the willingness to nurture each other.
- https://mychildrenschildren.com/five-lessons-from-a-medical-careerand-life/
- https://youtu.be/SVGNjWPGVbA?si=_KP3yXIdlvObSadB
- https://mychildrenschildren.com/catch-relational-health-at-its-best/
- https://mychildrenschildren.com/em-within-pathos-suffering-empathy-revisited-2025/