By Rod Moser, PA, PhD
I love working with babies, because babies are usually the best smilers. As soon as I walk into the examining room, I regard the patient first and greet them with a warm and welcoming smile, even if that patient is a little baby. This usually sets the stage for a productive visit, not just for the patient, but for me as well. When you smile, the world tends to smile with you. Of course, if you smile too much, people may think you are just crazy.
Smiling should be an essential part of all human encounters, either face-to-face, or on the phone. Our employees are instructed to smile when they are talking on the phone to patients. It is felt that smiling will actually communicate through their voice and promote a friendlier interaction.
A study at the University of Kansas – a state where people tend to smile (except in the winter) found that smiling reduces stress. Participants in this research study who smiled were less stressed doing various tasks than those with neutral facial expressions. Stress levels were especially low in those with genuine smiles. Even those who forced a smile during an unpleasant task seemed to have lower stress levels.
A medical practice can be unbelievably stressful and we never know what is behind that examining room door until we open it. Sure, we sort of know why a person has made the appointment, but this isn’t the full story. That story begins with the introductions, and sometimes with the opening smile.
There are all types of smiles. There is the obligatory smile that is required because I smiled first. This is sort of like a weak handshake without the transfer of germs. If the person who smiles immediately goes back to a furrowed frown, then I take this into consideration. I frequently encounter false smiles. This is often from a person is either upset or stressed. They may be rushed or we may not be on time in their rushed opinion. This smile is brief and may even resemble a sneer. Most people will detect that it is not really genuine.
Babies and children are unbridled by social constraints, so you can count on their smiles to be real. Genuine smiles are the best. A genuine smile lowers the babies’ stress level in unfamiliar surroundings with unfamiliar people, and it definitely lowers my stress level. I live for those toothless smiles.
Humor is an integral part of my practice. Humor makes people smile. If it doesn’t, you need to stop trying to be funny. I like to tease the little kids that I know, saying things like, “Hey, I thought you were in jail?” I will look at the chart and notice that they are here for a sore throat and an earache, but will add “stinky feet” to the list of complaints. Most will smile. Some will admit that stinky feet is one of their concerns. When I look in their ears, I am looking for birds. If this doesn’t make them smile, the little bird whistles that I make while I am examining them will do it. When I look in their noses, I always make a booger comment. The words booger and fart are perhaps the two that cause the most smiles in children. Incidentally, I can say those words in a few different languages.
When I was a student making hospital rounds, I had the chance to examine a patient who I felt was having kidney stones. When I reported this to my attending physician, he came to the bedside to make his own assessment. He made a little humorous comment to the patient, and she smiled. He shook her hand only and did not examine her. We walked out of the room together and he told me that she did not have kidney stones. Since he did not examine her, I questioned his diagnosis.
“People with kidney stones do not smile”, he calmly told me. He smiled and walked away.
He was right. She did not end up having kidney stones.
Thirty-five years later when I had my own kidney stones, I finally understood.