As the deadline approached for her science project last spring, Culver City fifth-grader Kiana Deane chose a familiar subject: herself.
Since birth, she had been afflicted with an uncommon form of paralysis called Bell's palsy that left her unable to smile. As far back as she could remember, children would stare at the empty look on her face and ask: What's wrong with you?
She decorated her science poster with photographs of her own face, staring outward with that blank, emotionless look of fashion models whom she admired because their expressions were like her own.
Her project was also a plea for her classmates to look behind her face to the girl inside.
"I get teased, questioned and misjudged because I am unable to smile," the 11-year-old wrote. "Well, maybe I don't have the muscles or nerves to smile, but I have kindness, respect and I am going to live a successful life."
In the human face's infinite patterns of expression, a smile springs from one of the most basic motivations -- the desire to connect with others.
Next to blinking, smiling is the most common facial expression, performed almost reflexively to convey a range of feelings: pleasure, embarrassment, friendliness.
To have no smile is a rare burden. Some say it is like being trapped behind a mask.
Bell's palsy is the default diagnosis when the exact cause of facial nerve damage isn't known. In the overwhelming majority of 40,000 cases reported in the U.S. each year, the paralysis is temporary and resolves in a matter of months without treatment. Most cases involve older adults.
For those who fail to recover, the condition can be devastating. Karen Schmidt, a biological anthropologist at the University of Pittsburgh who studies emotions, has worked with teachers and lawyers who have quit their jobs because they believe they can no longer be effective without the use of their faces.
What these patients miss most is their ability to smile, Schmidt said.
Chiara Walters, 34, said people stopped smiling at her because she could not smile back, and the children in her Louisville, Ky., classroom thought she was mocking them with the pouty look her paralysis brought.
Debbie Lawlor, 54, of Fairfield, Ohio, who came down with Bell's palsy 14 years ago, said she yearned to let her grandchildren know that she was happy and not making faces at them.
For a child, the loss is immeasurable.
"A smile is, like, everything," Kiana said.
