A Smile Is Worth a Thousand Words

Recently, I had a patient that had suffered a brain injury that had left her unable to speak. Pressure on her brain, seemed to put a block against her ability to recall and speak words. Often times, stroke patients suffer from this same problem. For some its a permanent problem and for others, speech will return. The question that always comes up is how much will a person with a brain injury be able to recover with proper rehab?
Where this lady lacked in speech, she was able to make up for with the most beautiful smile. Her smile conveyed years of gentle kindness to others. It revealed how much she loved her friends and family. It told me that she was placing her well being and trust in me to care for her. Honestly, her smile was her protection from people losing patience with her lack of abilities. If there is a human being that could be cruel or neglectful of someone who could smile so preciously, then that person has no heart.
This beautifully smiling lady, has a very large family. Taking in others in need into her home is a regular practice for her. She never has met a stranger. All of this is very apparent in her expressions. And to add to this beautiful smile, one day she said to me,"Yes!" When she spoke to me, I turned and looked into her bright face. She knew what she had just done. I wanted to cry tears of joy! How amazing! And it was a purposeful YES! She was answering a question I had asked.
 I always have spoken to people despite their ability to communicate. I can not imagine being stuck on a vent or having a trach and not being able to speak. Day after day, people walk in, complete a task and leave the room. What if no one took the time to consider that the person lying there in the bed, motionless and quiet, had a mind that was working 100 miles an hour?
After YES, she had me! Then she began to laugh. At times that laugh was a giggle like one would hear between two close friends sharing a private joke. Once I asked her if she had pain in her leg, her response was a clear and profound,"NO." I drew close to her face and she grinned from ear to ear. I told her,"I LOVE YOUR WORDS!" She was so proud of herself. I couldn't have been more happy for her.
On my most recent day of working with my sweet lady, she had been suffering with a pain that her daughter and I could only figure had to do with her stomach. She was terribly uncomfortable and cried out. Her face, twisted up into the most awful expressions. The beautiful smile that I would have jumped through hoops to get to see, was hidden behind pain. It hurt my heart to see her so miserable. After many attempts to try to relieve her pain, I came back into the room saying,"hey sweetheart, how are you doing now?" She turned to me and said,"Hey sweet heart!" Then she giggled a little knowing that she had saved the big guns for me! I know I was beaming. I had finally been able to manage her pain but I also got to hear more complex words.
People always ask me if their loved one that is in a coma or in the final stages of their life can hear them or know they are there. I believe with all my heart that this is true (unless the person is completely brain dead and their soul has already left the shell of their physical being and gone home). I suggest that people always talk to their loved ones even if they think they cant hear them. The same goes for people that are seemingly "not home" or have suffered brain injuries. Just like this little lady, if we never spoke to her or took the time to listen, we would not have been able to appreciate her precious smiles but also, we would have missed those words. Those words start out small and as she grows in confidence and is able to recall more words, she will speak again. I hope I get to hear what she has to say! And whatever is on her mind, I know that because of her beautiful spirit, it will be followed with a laugh and a smile!