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    All the more reason to smile


    Hey, hobo man, hey, Dapper Dan

    You've both got your style
    But brother you're never fully dressed
    Without a smile.

    —“Annie” (Soundtrack from the motion picture)

    Dr. McDonnell

    By Peter J. McDonnell, MD

    Matthew Hertenstein is a psychologist at DePauw University, Greencastle, IN, who has studied the photographs of children and high school students and then determined what happened to them later in their lives.

    It turns out that people who smile more warmly in their photos when they are young will allegedly live longer and happier lives.

    A “warmer smile,” according to the definition of psychologists, demonstrates contraction of the orbicularis oculi. This muscle gives “that proverbial ‘twinkle’ in your eyes,” according to these folks who study smiles.

    What are the data?

    • According to a study of college yearbook photos published in 2009, those who smiled least in their photographs were about five times more likely to divorce at some point in their lives compared with those who smiled most.
    • A second study of people aged 55 to 91 years examined their photographs from childhood (average age, 10 years). Again, the more smiley the subjects the less likely they were to experience divorce.
    • A 2001 study found that women with warm smiles in their college yearbook photos experienced less anxiety, sadness, and despair in the 30 years after graduation. They reported being more socially active and feeling more fulfilled than non-smilers.
    • Professional baseball players smiling warmly in photographs taken in the early 1950s lived, on average, until the age of 80. Sadly, the ballplayers who weren’t smiling died, on average, at the age of 73.

    According to Prof. Hertenstein, “smiling behavior predicts surprisingly large number of outcomes that people care about.”

    “But,” we are told, “your smile, or lack thereof, is not the great determinant of your destiny. Individual cases will certainly vary.”

    What does your photo say about you?

    Upon reading this, I quickly inspected my photo in this publication, as well as those on my walls and shelves.

    From that exercise, I concluded that:

    • My orbicularis oculi musculature is being used, and therefore, I will live to be at least 80 years old.
    • It is kind of pathetic for a grown man my age to have so many photographs of himself in his office.

    These data about smiling yearbook photos reminded me of the time the photographer came to my grammar school, St. Peter’s, in my little Jersey shore town. Our mothers took us for haircuts the day before, combed our hair that morning, and made us dress nicely (we wore uniforms with clip-on ties).

    “Be sure to smile,” they said.

    But a couple friends and I agreed that we did not want our photos taken and we would refuse to smile for the dumb photographer. When the time came, I sat down on the stool with the fake background and didn’t smile.

    “Who are you supposed to be?” said the photographer. “Elvis Pretzel?”

    To a 7-year-old boy, this was such a hilarious joke that I burst into laughter and he took the photo.

    “Thank you,” he said, and we were done.

    What does this research mean for you, dear Ophthalmology Times reader?

    My own theory is there may well be something to this idea that smiling is good for us, and we would be wise—in our clinics and operating rooms—to exercise our orbicularis muscles as much as possible.


    • Hertenstein M. The Tell: The Little Clues That Reveal Big Truths about Who We Are. Basic Books, 2013.


    Subscribe to Ophthalmology Times to receive the latest clinical news and updates for ophthalmologists.

    Peter J. McDonnell, MD
    He is director of The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, and chief medical editor of ...

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