Liver disease patients arrive relatively late to hospitals, often with misty eyes, wasted facial and body muscles, itch marks, and tummies bloated with water. They come from far off places, in despair, with a hope to get back their lives. The least they can be met with is a reassuring smile: a smile that shows that their their pain and fragile health is not unseen. A smile that says the doctor will give their utmost to help and heal them. It is said that a blissful smile added to bitter tinctures is the fastest healer. What motivates a doctor most is when the patient shows signs of recovery. It is then, that one gets the most addictive reward for a clinician, the “smile”, from the patient and his family.

That ‘return smile’ is a weakness. It feels incomplete and defeating if, after explaining the disease and initiating appropriate treatment, the patient’s face does not light up with a smile. This reward had been a driving force, like a freshly brewed filter coffee; something one never pondered upon before these unprecedented times. Recently, after hospital rounds, for the first time, I felt slightly tired. This was despite less work and most of my patients actually doing better than before. On any other day such patient recovery would have given spring to my shoes. That is when I envisaged what was missing in my day: “the smile”. This was probably because of the mask that patients and their relatives were wearing. All their faces looked alike, hidden behind a three-inch blue cloth. Normally, the facial agony of the patient is haunting. Now, even if it is hidden, the sight of the mask is disconcerting.

Most physicians work for this return smile, which can not be weighed monetarily. Though, the onus often lies squarely on the doctor to bring smile out from the patient, it is sometimes the gesture of the patient which heals the doctor.

A smile stimulates the recuperative powers of the ailing patient into action. Hippocrates believed in the ‘body-mind relationship’: to affect one is to affect the other.

During pandemics such as the current Covid-19, wearing face masks is common practice across the globe. A face mask covers the wearer’s nose and mouth and acts as a physical barrier to potential contaminants in the immediate. This is not new. Even in the days of the the Spanish Flu, which infected nearly one-third of the world and killed about 50 million people, the use of gauge masks was mandated for one and all. Unfortunately, there is little information available on the psychological trauma of wearing a mask in that era.

Of course one wears a protective mask, before arriving to the hospital because everyone is worried about contracting Covid-19. This is for everyone’s protection — doctors cannot help patients if they themselves are sick. I understand that patients, who come to hospital take a calculated risk, between contracting Covid-19 and getting proper diagnosis and treatment. In such stressful situations, the doctor’s positive smile is a reassurance.

Smiles can help people overcome hardships in Covid times. It can transform our daily lives at metabolic, psychological, social and even political levels.

When iPhones can show smileys, can’t we develop masks which can show emotions! As we will have to live with masks for quite sometime, it would be worth a while to have a variety of ‘lively masks’. At least doctors need such a mask while treating patients. And if the patient can give a return smile through this unique mask, we would never feel tired. As a colleague says: “We will not feel or dream of Covid infection, if we can work to bring back smiles on the faces of our patients. Indeed, if I can see this, with or without a mask, I would be able to retire to bed with peace and comfort.”

The writer is Senior Professor, Hepatology and Director, Institute of Liver and Biliary Sciences, New Delhi