Writer with Bell's palsy ponders how to experience joy when expression is limited

Toward the end of her new memoir Smile: The Story of a Face, playwright Sarah Ruhl parses the distinction between the disappointing and the tragic: "Disappointing things were not for the written word, disappointing things were for the stiff upper lip. Tragic things are for the written word, because in tragedy there is catharsis, not slow, incremental, often invisible progress."

The "disappointing thing" here that Ruhl thought for so long did not deserve to live on the page is her ten-year affliction with the idiopathic — spontaneous, unexplained — condition Bell's palsy, which renders the muscles on the left side of the face paralyzed or weakened due to a damaged seventh cranial nerve. As mysteriously as they descend, about 85 percent of cases resolve on their own within three months; 95 percent resolve within a year. Ruhl's falls in the small percentage that persist permanently, suppressing her smile.

This condition is, indeed, not a calamitous one, especially when considered in the context of a pandemic that has killed one in 500 American residents. Ruhl is aware of how "small" her "half-smile problem" seems, especially as her life has been blessed with "abundance." In the same year that her Bell's palsy appeared alone, she mounted "In the Next Room, or the vibrator play" on Broadway, which was nominated for a Tony Award for Best Play and a finalist for the Pulitzer Prize for Best Drama. She also gave birth to twins, making her a mother of three. It was in the maternity ward, a day after delivering the twins, that Ruhl's face fell. (Bell's palsy is more common during pregnancy and the postpartum period.)

But while the condition is not life-threatening, it can be life-altering precisely because it affects the face, and the smile — the ability to communicate our interior feelings to the world outside of us. As Ruhl notes, not being able to smile presents a conundrum: "How to experience joy when you cannot physically express it?" In this way, the merely "disappointing" merits deliberation.

But while Smile records Ruhl's coming to terms with her new face and the conundrums it presents, it is not limited to "the story of a face," as the memoir's subtitle suggests. For much of the book, Ruhl's condition recedes into the background as she accounts for the goings on of her life over the ten years since her "smile walked off [her] face." Ruhl organizes the book into 32 short chapters, and the first 24 give the feel as much of a memoir of parenting very young children while working as a renowned playwright as a memoir of illness. This is in part because Smile proceeds linearly, and about two-thirds of it takes place in the two years after Ruhl's twins were born and thus after her Bell's palsy diagnosis, with interstitials that scatter away to abstractly explore smiling, symmetry and asymmetry, beauty standards, and loss.

Ruhl's writing on parenting and theater is engaging and insightful, especially in a chapter titled "Three Children Under the Age of Five and Three Kinds of Vomit." Her broader ruminations on topics like Mona Lisa's smile and the idea of having a "good side" are similarly compelling, though a riff on the prevalence of asymmetry and disfigurement in pop culture villains ("Captain Hook. Darth Vader. Doctor Poison in Wonder Woman.") weirdly waltzes past deeper consideration of why disabilities are coded as evil. Later, Ruhl gives credence to the practice of physiognomy without noting that this pseudoscience was used to provide "evidence" for racism. These digressions — some of them belabored with explanation that does not trust the reader's intelligence (do we really need a primer on what gluten is in 2021?) — began to feel as though they served to avoid dwelling on Ruhl's personal experience of persistent facial paralysis and treatment thereof.

Ruhl does transmit what her condition felt like physically — "My face felt like a system of moving parts: this part moved, that part didn't. I felt like anatomy rather than a whole" — and emotionally — "I was full of self-blame for my face not getting better." These insights allow for the reader to empathize, a crucial function of any illness narrative. But for much of Smile, she resists ascribing meaning to her decision-making around her Bell's palsy. She notes at several junctures that she determined not to seek further treatment, that she ducked googling her condition for nearly two years, that she had again given up on getting better, that she didn't call her neurologist friend to discuss her condition in detail until nine years had passed. It is not until the last 50 or so pages of the book that she begins to grapple with why she evaded her own face. The revelation that comes — "I realize I have had such shame over my broken face that I have not even attempted many subtle expressions for a decade" — does not feel like one that needed to be held off on until nearly the end of the book, even if it took Ruhl ten years to ascertain.

At the end of Smile, Ruhl writes, "My many years of writing plays tells me that a story requires an apotheosis, a sudden transformation. But my story has been so slow, so incremental; the chronic resists plot and epiphany...A woman slowly gets better. What kind of story is that?" Like Ruhl's initial belief that "disappointing things" don't warrant "the written word," and the padding of the book with tangents, this betrays a reluctance to tell a story that feels small and slow — odd given her work as a playwright to "make the small, quiet moments theatrical." Her mistake is that memoir does not require a single epiphany, but would do well to offer many moments of retrospective meaning-making.

Kristen Martin's writing has also appeared in The New York Times Magazine, The Believer, The Baffler, and elsewhere. She tweets at @kwistent.

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