There is a line that I love from the movie Madagascar, which has become a mantra in my life: “Smile and wave, boys. Smile and wave.”
Someone is rude? Smile and wave.
Someone cuts you off when driving? Smile and wave.
I have smiled and waved a lot in my life, often related to my speech. I stutter. I am not nervous, hesitant, or unsure of myself. Rather, there is some neurological issue that is frankly far too complex for my understanding which leads to a repetition of sounds and blocked words.
It starts with a blockage in my throat and leads to squinting eyes and pursed lips in an attempt to force the words out, making it challenging for my breath to keep up with my voice. I can feel it coming before it happens and often have enough time or foresight to change my words to ones that will leave my mouth more smoothly.
While the embarrassment of the stutter has lessened with time and my fluency has increased with intensive speech therapy, the stutter will always be there. The deep guttural Gs and lip-smacking Ps will always be my hardest, but I’ve learned ways to compensate.
Experience has taught me to not let this speech impediment define who I am or what I do. It took time and motivation to get here. I have worked hard throughout my life to obtain some semblance of fluency, devoting countless hours to after-school speech therapy, week-long speech intensives during my time off, and practicing saying my name while sitting on the floor in front of a mirror on nights and weekends.
I am not a shy person but, because of my stutter, I often dread occasions that require public speaking: introductions, doing rounds in the hospital, reading out loud, and presenting at a podium.
I smile and wave when, following these routine tasks, I am told “You don’t have to be so nervous,” “Don’t be scared,” or “Take a breath.” I wish fluency was that simple. I smile and wave instead of verbally responding, recognizing that most people are probably truly trying to help.
Though this reaction may seem passive (I should stand up for myself!), the opposite response feels trivial compared to what goes on every day in the hospital, where many patients are experiencing significant, life-changing events.
These comments – and smiling and waving – have become part of my daily life. I perform these tasks anyway, knowing logically that any judgement of me based on a few scrambled words or repetitive sounds is more a reflection of others than myself.
But don’t be fooled – it has taken a lifetime of effort to get to the point where I am comfortable with executing these tasks. I choose to smile and wave, even if it has led to tears, unsolicited advice on medical school evaluations about ‘hesitancy’ and a stutter. My general approach is that stuttering through a presentation is a better than not doing it at all.
The point is not that I am some brave warrior who deserves praise for doing hard things. Life is full of hard things – that is OK. A stutter is small on the list of things that people deal with, hence my smiling and waving. People do hard things every day.
Though smiling and waving has been a personal motto, one particular interaction made me reconsider this approach. While talking to a member of my team, my words became tangled. A block in my throat led to airlessness and the inability to produce sound. I paused, took a breath, and attempted to start again, but was quickly interrupted – “Use your big girl words,” I was told. I was taken aback but smiled and waved. I forced a laugh, left the room, and have been bothered by the exchange ever since.
I have spent most of my life smiling and waving, generally unbothered by the comments I’ve received. Why now, a long time later, am I still bothered by this interaction? I can deal with laughter, strange looks, and confusion. But it was the implication that I was failing to communicate without being given the chance that didn’t sit right.
Reflecting upon my experience as a trainee with a stutter, it has – perhaps paradoxically – taught me a lot about communication. Having a stutter has taught me to be thoughtful and to think ahead. I’ve learned how to perform under pressure and overcome embarrassment. In undergoing speech therapy, I’ve learned diaphragmatic breathing and how to manipulate my muscles to facilitate fluent speech; though the speech may sound slow, it may also come across as thoughtful and patient. Stuttering has taught me the importance of giving people grace instead of rushing to assumptions.
Someone recently asked me how I got to this place in my training. I laughed then proceeded to list my many failures and struggles that propelled my nonlinear path. We all have weaknesses. We cannot be afraid to pull back the veil of perfection that so often plagues us as trainees. And we must stop perpetuating the smile-and-wave mentality when it comes at the expense of human decency. Smile and wave, but also stand up for yourself when the situation is right. I regret not doing it sooner.
Dr Rachel Goodman is a cardiology fellow at Tufts Medical Center and chief fellow at the CardioNerds Academy. She completed her residency and chief residency at the Medical College of Wisconsin and medical school at the University of Michigan. Her career interests include advanced heart failure and transplant cardiology, critical care cardiology, and medical education.