Writers, including playwrights, traffic in expression. From turning phrases to detailed descriptions to dialogue, we rely on writers --- and the characters they create --- to shine light on our lives, reflect our experiences and offer us new perspectives. Sarah Ruhl, a celebrated and award-winning playwright and writer, is expressive by trade. But, as she details in her memoir, her own physical expression came to be both a challenge and an opportunity to understand herself in new ways.

Ruhl already had seen great professional success and was happy in her marriage and in mothering her daughter Anna when her twins, William and Hope, were born. The pregnancy was difficult, including bed rest to treat cholestasis of the liver starting in her 25th week.  But the focus of SMILE is Ruhl’s Bell’s palsy, a medical condition in which the face muscles are suddenly weakened, making one side of the face droop and keeping one eye from closing or blinking. Its exact causes aren’t really known but may be connected to a viral infection or diabetes. It also can occur during pregnancy or in the postpartum period.

"SMILE is a fascinating and moving 'story of a face' that both masks and reveals a depth of feeling. Ruhl is an honest storyteller who is unafraid to share the intimate and the humorous particulars of her life with Bell’s palsy."

Soon after delivering her twins, a lactation consultant noticed that Ruhl’s eye was droopy; a stroke was ruled out, and she was diagnosed with Bell’s palsy. “The left half of my face had fallen down,” she writes. “Eyebrow, fallen; eyelid, fallen; lip, fallen, frozen, immoveable... I was astonished --- my face hadn’t felt any different before I looked in the mirror. Before looking in the mirror, I was the same person. After looking in the mirror, entirely different.” For most people, Bell’s palsy is temporary, resolving in days, weeks or perhaps months. But for Ruhl, it is permanent, and it was a decade --- the years chronicled in SMILE --- before she saw positive progress in her condition at all.

Those 10 years took Ruhl through an exploration of family, work and modes of expressive communication while re-examining her Catholicism and studying Buddhism. But most importantly, and so honestly described, she probes her relationship to her own self: her self-identity, her physicality, and her frustrations and fears living with Bell’s palsy and navigating the world with a face she cannot control. SMILE moves through time fluidly, avoiding a simply chronological telling in favor of a more organic searching of emotion, response, ideas, and transformations both physical and emotional. Ruhl draws on the work of other writers, as well as painters, religious teachers, doctors and scientists --- even Greek mythology --- to illuminate her thoughts about illness, parenthood, partnership, creativity and her profession.

Throughout, Ruhl chases the possibility of healing, though over time what healing actually means for her comes into a sharper and more refined focus. From traditional western medicine to traditional eastern medicine, she takes advantage of various treatments such as physical therapy, chiropractic sessions and acupuncture. She comes across careless doctors, creepy doctors, and those who listen with patience and mindfulness. In a medical culture that understands very little about Bell’s palsy, it was through the creative thinking of a few individuals, and Ruhl’s own dogged pursuit of the matter, that healing began to take place.

SMILE is a fascinating and moving “story of a face” that both masks and reveals a depth of feeling. Ruhl is an honest storyteller who is unafraid to share the intimate and the humorous particulars of her life with Bell’s palsy. In the end, the book transcends this diagnosis and becomes a rumination on the wisdom found in literature and in friendship, the force of religious belief and spiritual seeking, the magic of long-lasting romantic love, the fragile, powerful joy of motherhood, and the importance of being kind and loving to oneself.