My COVID Diaries: is that a smile under the mask?

Is that a smile or a grimace? Is she listening to what I am saying? Does she care about my animal?

Most of us became veterinary surgeons out of a love for animals – but as we all know, ours is a people job. We deliver complicated – sometimes distressing – medical information, searching for words we hope will help our clients understand. But it is through non-verbal communication that we express our kindness and compassion: the bit they remember.

When we greet clients and colleagues, we smile before we speak. That smile welcomes, reassures and lets them know they are important to us.

Covered

On 24 July, wearing face coverings became compulsory in enclosed public spaces. Many of us have been wearing them for some time in practice, and now many of our clients are doing the same. We are all doing our bit to reduce the spread of the virus, but, in doing so, we have covered up our smiles.

Through lockdown I have had a few consultations that just did not seem to go how I had hoped. A million reasons exist for this – from heightened emotions, to mismatches in expectation of COVID precautions and anxiety around not accompanying pets into the building. But I suspect a big part of it is that we are struggling to read each other.

Most non-verbal communication comes from our mouths; whether it is the way we turn our lips, or how we nuance our words. We intuitively show empathy by mirroring each other’s facial expressions. But what if we cannot see them?

It may sound bizarre, but I tried sitting in front of a mirror wearing my personal protective equipment (PPE). I was surprised by how little of my facial expressions could be seen compared to what I expected – particularly my smile.

Learning to ‘smize’

You may have heard the saying that a smile is not a true smile unless it reaches the eyes. Supermodel Tyra Banks coined the term “smize” to describe smiling with your eyes, and this technique is now used by actors and models to harness the expressive power of our eyes.

I started practising my smize in front of the mirror, wearing my mask. Initially it was impossible to tell when I was smiling; my attempts at a smize were more akin to an expression of pain.

The key, I learned, is to embrace your crow’s feet (they are not called expression lines for nothing), raise your eyebrows and lift your cheek muscles. After a bit of practice, I began to get it.

The communication skills we need are still the same, just with a flare of pantomime to help them be seen.

Maintaining eye contact may feel uncomfortable, but it shows you are interested in what the other person is saying and gives a sense of self-confidence. Exaggerating nodding your head and making small sounds shows you are actively listening.

You may feel like a grinning, nodding Cheshire cat initially, but if you practise in front of the mirror you will see it is not as obvious as you may think behind all that PPE.

Face coverings are going to be a part of life for some time, so developing a winning smize is a real investment – at work and in our personal lives.

Verbal skills

Of course, we must also lean more heavily on our verbal communication skills.

Like many of you, I was taught the “chunk and check” method at vet school – repeating back to the client a summary of his or her concerns to show you are engaged and check you are both aligned in your understanding.

Now I cannot rely on my body language so easily, I have found it a helpful technique. Reassuring a client that you understand his or her concerns is particularly important if the next step is to take his or her animal away to examine alone.

Communication skills are paramount to every interaction. But they are even more important with someone who may have greater difficulties picking up on them behind a mask, such as those with impaired hearing or sight, or conditions such as Alzheimer’s or autism.

If we cannot use non-verbal skills to express our emotions, sometimes we may just need to say what we are feeling out loud instead.

It has never been more vital to show each other compassion and kindness, and a mask need not be a barrier to that. We can smile with our eyes, listen actively and show we care just as much as we always have.