Smiles

It feels like wading into cold ocean water. A bit of a shock, and then so refreshing. I step hesitantly out of my office, and then amble down the hallway toward the exam room to see my patient. Both of us will be unmasked. The natural state now requires getting used to all over again.

Face masks are now optional in our primary care practice, in the absence of acute respiratory symptoms. How nice to breathe from a room full of air rather than from recycled boluses, to see through unfogged glasses, prepare to offer and receive a full range of facial expressions. Things I used to take for granted now seem like gifts.

Yet still lurking beneath these soon-to-be rediscovered pleasures is vulnerability so deeply etched that I imagine it will linger for a long time. Before the pandemic, my health never felt so palpably at risk in practice, and it is hard to erase that feeling. Being in proximity to a cough or sneeze was something to avoid, but not fear. Now with reduced COVID prevalence, vaccination and effective treatments, that fear has waned considerably, but I still feel a twinge of anxiety around respiratory noises and cannot help imagining tiny, spiked spheres racing around in search of a host.

Matching the joy of unmasked faces against lingering apprehension, I am sure joy will be the clear winner. Especially the smiles. I recall a patient I saw years ago, before the pandemic, on a busy Friday before a holiday weekend. She was thin, frail and struggling to move air in and out of her lungs. I knew how disappointing it would be for her to go to the hospital, let alone just before a holiday. Her breathing seemed to calm a bit when she spoke of her family, or maybe I just imagined it. I held her thin, arthritic hand and explained the treatment plan, then wished her a peaceful night.

“Thank you for helping me,” she said.

“What did I do?” I asked.

She paused to clear her throat and looked up at me. “You smiled.”

I reach my exam room destination, knock, and open the door to greet my next patient with a smile, like a great loss reclaimed.

Jeffrey Millstein
Woodbury Heights, New Jersey