It will be close to springtime when this editorial is published, although I am writing it on a cold and rainy afternoon in February. It is difficult to predict what the future will bring, even a few weeks from now. But I recently experienced a nice harbinger of spring; the temperature reached 70 degrees yesterday in North Carolina, and it seemed as if everyone I know was out walking. I was suddenly spotting friends and neighbors I hadn’t seen in months, all with smiles across their faces. Yes, faces. I hadn’t seen those in months, either. Sometimes, it’s the little things we notice that make a difference.
Most of us are aware of just how important faces and facial expressions are when it comes to nonverbal communication, especially for certain populations. For instance, our deaf and hearing-impaired patients rely heavily on nonverbal cues to interpret what we are communicating. I was recently reminded of this in clinic when a patient asked me to remove my mask (he kept his on) so he could read my lips. I complied, of course, but the experience made me wonder how many other patients have struggled to understand what I was saying because I was wearing a mask. Even for our patients who can hear, nonverbal expressions are an important form of connection between people.
I am really hoping that by the time you read this, our latest surge will be well behind us and some of our health restrictions will have been lifted. After we have been given the go-ahead to remove our masks, it will be important to recognize what we have missed in our masked conversations with patients. In cancer care especially, so much of our ability to treat patients with incredibly potent but risky medication is built upon trust, which is established through an empathic connection. When I think about the toll that two years of masked interactions has taken on our ability to connect with patients, I wonder just how much our masked faces have alienated us from them. This is not a statement against masking, but rather a recognition of the unfortunate consequences of this otherwise valuable measure.
For many of my long-term patients, the removal of masks will be a welcome reconnection to the faces of the people whom they have long entrusted with their care. The difference will be even more striking for those patients who started to visit our practice over the last two years—most of these people have never actually seen my entire face! The first time we have a visit without masks on, they may find it strange to witness my expressions as we converse and discuss their latest findings or symptoms. Empathy is expressed as much through these nonverbal cues as by any words we share. Even touching, something that we have at times refrained from doing during this pandemic, can be a subtle but important form of comfort.
Whether or not we are yet there, please keep in mind that whenever the time comes for us to see patients without our masks on—whether it is the first time or the first time in a long time—be conscious of your facial expressions. They may have a bigger effect than you realize.
Sincerely,
Daniel J. George, MD