Smile: The Story of a Face by Sarah Ruhl review – a bruising battle with Bell’s palsy

The playwright’s fascinating book shows how a decade-long struggle with the condition profoundly affected her sense of self

A writer does not need to smile – on the page, words can do the smiling. This is something you are aware of throughout American playwright Sarah Ruhl’s extraordinary tale of being struck with Bell’s palsy a day after giving birth to twins. The first sign something is awry is when a lactation consultant casually observes that one of her eyes looks droopy. And when she gets up to look at herself in the bathroom mirror, she finds that the left side of her face has “fallen down. Eyebrow, fallen; eyelid, fallen; lip, fallen, frozen, immovable.” The smile she has, all her life, taken for granted is gone. She explains that, before seeing her reflection in the mirror, she was one person. Now she is another. But she is not self-pitying. Her prose is smart, quipping, pacy. It has the quicksilver mobility her face lacks.

She was unlucky: for many people, Bell’s palsy passes quickly. Hers proved depressingly tenacious. Ruhl describes a decade of paralysis but begins with her pregnancy (her second – she has a daughter at pre-school). Her account brought back memories (having had twins myself) of an in-body experience that at times seems almost an out-of-body experience, a physical overachievement that doubles as a hitch, a risk, an extravagant burden. She writes vividly about the marathon of early days after birth: “The sleep deprivation when breastfeeding twins can feel like a form of psychosis”, yet she does not neglect to celebrate her children, their joyous existence. Charmingly named after the intersection where she and her husband Tony (a child psychiatrist) met in Providence, Rhode Island - “Williams Street and Hope Street” - their twins are called William and Hope.

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