By HÃ©lÃ¨ne Epstein
It is the voice of a woman, mother, sister, daughter, friend, patient and author who wrote a memoir on her own terms. I look forward to Sarah Ruhl’s next play.
Smile: the story of a face by Sarah Ruhl, Simon & Schuster, 256 pages. $ 27.
If you like Sarah Ruhl’s pieces like me (The clean house and the dead man cell phone), you will be happy to spend time listening to the playwright speak in her own voice. “I have always preferred the discursive reflections of Montaigne to the self-revelations of Augustine”, she writes in her memoirs. Smile, part of an autobiographical intellectual rather than confessional tradition. She chooses to tell her story – that of a contemporary writer, a wife, and a chronically ill mother – in a style that straddles rather than focusing on a sustained narrative.
Smile Its title derives from Bell’s palsy, a disease she contracted in 2010, the day after giving birth to twins barely 36 weeks after a high-risk pregnancy. Ruhl, who has a devoted psychiatrist husband named Tony and Anna, a three-year-old daughter, is in her hospital bed, breastfeeding one of the tiny twins, when her lactation consultant unexpectedly says: “Your eye is on. ‘falling air’.
âYes, my eyes are a bit droopy,â replies the playwright without wasting time, âI’m Irish. “
âThat’s not what I mean,â says the lactation consultant.
When Ruhl stands up and looks at himself in a mirror, she sees: âThe left half of my face had fallen. Eyebrow, fallen; drooping eyelid; lip, fallen, frozen, stillâ¦ I tried to move my face. Impossible. Puppet face, cut strings.
Ruhl fears she may have had a stroke, but the neurologist’s diagnosis is Bell’s palsy. She is told that sometimes the disease resolves in a few months (this is the case for her mother in three weeks); sometimes not. After ten years of many types of medical treatment, Ruhl learns that she is one of the five percent of the population with permanent partial facial palsy.
“The Greeks, Romans and Persians all noticed a condition,” she explains in one of the very short chapters that make up Smile, “in which the forehead could not wrinkle, the face was paralyzed on one side and facial spasms occurred.” For reasons not specified by the author, the condition was named after Sir Charles Bell, a 19th century surgeon. Two hundred years later, the cause of Bell’s palsy is still not well understood and there is no definitive cure. Some patients, like Angelina Jolie, recover quickly and completely; others partially; some remain partially paralyzed for the rest of their lives.
While her newborn twins remain in intensive care, Ruhl returns home with her husband and baby daughter, “disfigured” as she perceives and unable to smile at the people she loves most. Later, she makes a list of smiling idioms:
Every American girl learns to smile – with teeth, as Ruhl points out – from birth. In his profession, the theater, everyone knows the value of a smile and the drawbacks of an expressionless face. Ruhl comes to see his condition as an âasymmetryâ, or a âdisfigurementâ or a âbroken faceâ. Her smile resembles a grimace – which affects everything from smiling at her newborns to posing for photographers at a photoshoot for the Tony Awards. She can’t close her left eye, which has many unforeseen reverberations, from having sex to swimming in the ocean. She cannot completely close the left side of her mouth, making it difficult to speak consonants. When asked what is the name of her twin daughter Hope, she can only answer “Ho”.
A frozen face, Ruhl learns immediately, demands that its owner be prescient, be constantly aware of how she presents herself in a face-to-face conversation, and compensate for it.
In a mini-scene at the hospital shortly after the twins were born, Ruhl describes his fury at an abrupt, unnecessary nurse who calls her twins Baby A and Baby B. âI wasn’t used to my frozen face yet. “, Ruhl wrote,” and realized that I didn’t know how to be courteous to strangers without a smile. How do you do this, especially if you are from the Midwest, where a smile is almost a prerequisite for citizenship? “
As in many of his plays, Ruhl reflects on so many disparate things that Smile reads less like a medical memoir and more like a series of distant jazz riffs on a theme she returns to every few chapters. She does not bring all the autobiographical elements together in one place, but disperses them throughout the book. She was born a Catholic in Wilmette, Illinois in 1974 to a mother who loved and worked in the theater and a businessman father who died while in college. She married a child psychiatrist whom she met in Brown, with whom she lives in Brooklyn, New York. Now a Buddhist, she also writes with irony about her difficulties in receiving communion and her introduction to Buddhism by her children’s Tibetan nanny, Yangzom.
Ruhl first took a serious interest in theater at the Piven Theater Workshop in Evanston. Shethen studied drama with Paula Vogel at Brown University. But Ruhl’s scripts, Ms Vogel, and Ruhl’s many other theater friends only make appearances in Smile. What remains in your mind, apart from the irrevocable state which strikes her out of the blue, are her many interactions with the medical profession: the good, the bad and the indifferent specialists in neurology, psychiatry, physiotherapy, sleep, acupuncture, chiropractic, Reiki and the Alexander Technique that she consults. We learn why the best have been helpful. Early on, after an obstetrician / gynecologist dismissed her complaint of itching during pregnancy, Ruhl self-diagnoses online – as many of us do these days – and confronts her doctor with a diagnosis of cholestasis of the liver, in which bile seeps into the bloodstream causing terrible itching.
“More importantly,” writes Ruhl, “it can immediately kill your babies.”
Her doctor assures her that she has no liver cholestasis. It is a rare disease that affects one in a thousand women.
âBut I have all the symptoms,â I said.
âHow do you know that,â he asked.
âItchymoms.com,â I saidâ¦ A week later my test came back positive.
It’s another more attentive neurologist who takes Ruhl’s old, comprehensive medical history and finds out she has celiac disease. âI was often sick in my childhood,â she recalls. “I was probably missing a month or two of school every year because of an illnessâ¦ I was always vaguely aware that others seemed to have vast reserves of physical energy when I had very littleâ¦ Now I knew that my food fed me very little. ; it was basically going through me and my body was in a constant state of hyper-alertness or inflammation. In addition to embracing the diet fad of his many gluten-averse theater friends, Ruhl learns that celiac disease may also interfere with his recovery from Bell’s palsy.
If you are looking for a medical dissertation on learning to live with Bell’s palsy, you will be frustrated with this book and find it disjointed and everywhere. If, however, you like Ruhl’s voice and sensitivity, you’ll love spending time with her no matter where she decides to take you. My favorite riff – maybe because I rarely read about episodes like these – are her descriptions of being a playwright with children. I will quote her at length because what she describes concerns so many working mothers whether or not they have a chronic illness.
âBecause I couldn’t see how to travel with babies to theater openings and take care of them free to do my rewrites, I stopped doing theater openings outside of town. The one time I had ever engaged in an out of town production, I told the director I would be coming for the first week of rewrites and the last week of previews, rather than everything. the month of rehearsals. And I left the kids at home with Tony and Yangzomâ¦. “
âWhen I got to rehearsals, I was working on the rewritings on a regular basis. I had written the play before the babies were born, and now is the magical moment to realize language in three dimensions. I enjoyed the joy of collaborating with actors again, inventing an alternate world together in a play.
âIn the middle of that first week Tony called me: William was in the hospitalâ¦ As a doctor [Tony] felt able to handle this on his own, but he thought I should knowâ¦ I went home to be with Williamâ¦.
Ruhl’s son recovered but,
âDuring the week I was away, the twins had given up breastfeeding. When I tried to breastfeed them, they just looked me in the eye as if to say “huh?” “â¦ I went back to rehearsals for the last week of premieres and opening night. The previews are that magical, anxiety-provoking moment when you realize whether or not your play is performing in front of an audienceâ¦ I was incredibly relieved that the audience laughed in all the right places.
âAfter the showâ¦ the artistic director approached. I thought he might congratulate us – the audience seemed rambunctious – instead he berated me for getting so far during the rehearsal process. While others were drinking cocktails and partying, the artistic director told me that I was the laziest and most irresponsible writer in American theaterâ¦. “
The next morning he apologized.
âI like the excuses. It is not given in every life to forgive or to be forgiven. She continues: âCould my play have been better if I had been more present in the play, less torn between motherhood and writing? It’s possible. Was it also possible that I was ignoring certain notes that I was given, not because I was out of the room but because I disagreed with them aesthetically? Also possible. If I forgave the art director, why hang on to his words or write them down? Guess I’m sticking to her words in case a theater manager or a manager at another company that employs women is wondering what it’s like to be a breastfeeding mother trying to work. outside of the city.
It is the voice of a woman, mother, sister, daughter, friend, patient and author who wrote a memoir on her own terms. I look forward to Ruhl’s next play.
Helene epstein is the author of Joe Papp: An American Life, The Long Half-Lives of Love and Trauma, and eight other non-fiction books. She reviewed for the Artistic fuse since its creation.