Why I Continue to Smile When I'm Experiencing High Levels of Pain


I found this illustration a few months ago on Pinterest. A version of the top part hangs in emergency rooms and hospital rooms, but the bottom part is the one that truly captures life for some of us with chronic pain. I don’t know who created this, but this illustration made me laugh and made me feel that I’m not alone in my experience. Thank you whoever made this. I couldn’t have “said” it better.

For the first few months with chronic pain, my face looked like the top half of the illustration. Chronic, unbearable, 24/7 pain was something I had never experienced before, and its effects showed on my face. Now, after six years with essentially the same level of pain, I smile more than I have ever smiled before. We all put on masks when we go out in public, and this one has become mine. The perpetual smile. I should probably have my teeth whitened.

Why do I smile and try to act as normally as possible? I don’t know. Maybe it’s simply because it takes less effort. Don’t they say that it takes fewer muscles to smile than to frown? Maybe I’m just too exhausted to frown.

Maybe I smile because it puts friends and people around me at ease. Who wants to hang out with someone who looks miserable? It gets in the way of normal relationships. Friends want to be helpful and do things for you. And, although I am grateful for having good friends like that, I’m fairly young, and I don’t want to feel like a burden on the people around me. I want them to have fun and not be thinking about me when we’re together. Well, that’s a lie. I’m vain. I want them to be thinking about me, just not about my pain.

A pain chart with two rows. The top row looks like a chart at a doctor's office, with different rankings and different facial expressions. The bottom chart lists the different levels of pain – but all the faces are all smiling.
Source Unknown

Maybe I’m tired of answering the question, “How are you feeling?” I know friends and family ask because they care, and I’m lucky to have many people who want to ask me that question. But, when I’m out of the house or hanging out with people, I want to feel as normal as possible because the rest of my time, the time when I’m alone, is far from normal. Some days go something like this: bed, tub, kitchen, bed, kitchen, tub. The order may vary, and I try to be vertical when my kids come home, but that essentially describes many of my days, with Netflix and books thrown in.

Maybe I smile because I want to show people how strong I am. My life and my contribution to society have shrunk so much since I started experiencing this pain, that maybe I just want to show that some part of the person I used to be is still there.

Maybe it’s just vanity. I’m not useless. Look how strong I am. I can smile and act normally with pain that would put most of you in the emergency room. I am superhuman. Your jobs, careers, parenting, and all your contributions to society pale in comparison to my heroic efforts just to smile.

Maybe it’s like a saying that my dad repeated often. It’s an Armenian saying that roughly translates to “say you’re fine; you’ll be fine.” It was his version of what we would now call positive thinking. I’m not going to say that I am a positive thinker right now, not with this kind of pain, but smiling is a tiny first step – and it takes a lot less effort than positive thinking. It doesn’t require a change of personality, just a change of facial expression.

Do I smile all the time? No, my husband and children experience the top half of the illustration more than they should. I’m also good at shouting in exasperation when they don’t do things the way I like them to be done. But, that’s a subject of a much longer and much more complicated essay. For now, I can only smile constantly when in the company of my extended family, friends, and strangers. I’m not heroic enough to maintain a smile for the people closest to me.

Getty Image by adrianova_


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