Author’s note: I didn’t participate in sports in high school. If you knew me, I promise you would recover from your shock quickly. Instead, I worked after school at the local nursing home. Don’t worry, my decision to go to medical school was made long before I turned 16; this isn’t another “why I want to be a doctor” inspirational pseudo-parable. This is about a woman named Jane and what she means to me.
The cramped section of nursing home floor space reserved for dining held 13 weary souls, with seemingly no room to spare for conversation or levity. It wasn’t a tense atmosphere, but leaden, as if gravity had taken an interest in the nightly special. It was the kind of heavy silence that swallows the background noises of clattering cutlery, coughing and ringing telephones. I had adjusted to it, but Jane was always over-the-moon about it, as she was most everything. She never spoke, but the smile she wore spoke volumes, reaching past her eyes to touch your heart. Her words, not mine.
In that place, where I worked and experienced the progressive failure of mental and physical faculties, Jane was my lifeline. No matter my disposition, Jane’s silent contentment was consistent. It was like she held the secret to eternal bliss behind her smiling lips or, perhaps, she was picturing the staff in their underwear (or lack thereof, as I often suspected of my co-workers). To Jane, it was Christmas morning every time the sun inched its way over the horizon, each breath smelled like the crisp Rocky Mountain air, and all meals tasted like five star cuisine.
On that day, every resident received their usual nutritionist-approved meal from a hair-netted busy body with questionable fingernails as they occupied the seats marked by laminated placards. Jane waited for me to give her another please-don’t-choke-on-this-sized bite of somewhat recognizable chicken noodle soup purée. Catching the twinkle behind her stormy blue eyes, I struck up a one-sided conversation, trying to fill the time and the silence not fully broken by the sleepy drone of the NPR broadcast filtering in from the next room.
I told her about the salmonella scare with Peter Pan peanut butter and she smiled back. I told her about the school musical and she smiled back. I asked, “Do you think I need a haircut?” She lost her smile to an almost imperceptible frown for a fraction of a second and then remarked, in the croaky whisper of her long unused voice, “Oh honey, your hair is as pretty as chicken noodle soup.”
In over a year I had never heard her say a single word, and for the year after I would hear just as much. Every once in a while I would catch what I thought was the shape of a smirk on her lips, but it was probably imagined. I know she wasn’t smiling for me or the reasons I invented, but my spirit was no less lifted because I was aware of the reality. Jane knew that optimism preserves hope and comes from a glance inward, not outward. Jane knew that thinking the best of others is the surest path to treating others kindly. Jane knew that working in a nursing home could weigh heavily on a young man, wading in the waters of mortality and powerless to stem the current. Jane knew that a smile and kind word can change a life; that happiness isn’t a choice, but a series of choices; that patience isn’t a virtue, but a necessity. Jane knew the power of a cliché.
As I learn cardiac physiology, I wonder how it is that I can recall her face in vivid detail but not remember the causes of an S4 heart sound. In delivering bad news to a standardized patient, I wonder why the thought of her smile steadies my voice. I wonder if the image of her smiling face will ever fade in my mind and what it would mean if it did. Because I know she wasn’t smiling for me, but she was smiling, and that’s how I remember her still.