For the past three years I have been spending time at a facial nerve clinic in Boston, photographing people who have varying degrees of facial paralysis, a condition that usually occurs on just one side of the face. The causes are many, including Bell’s palsy, tumors, strokes, accidents, and congenital nerve damage. At the clinic, patients are offered long-term physical therapy, often coupled with Botox therapy. (Botox is used for medical as well as cosmetic reasons. It can be injected into areas of the face that are overactive, and can also be used to weaken the normal side of the face in someone with facial paralysis, providing more symmetry to the two sides). In more recalcitrant cases, surgery is an option. Most of the portraits in this series were made during a patient’s first or second visit to the clinic, before the beginning of treatment. In some cases, I have followed a person’s progress over time, and have been privileged to witness hope and excitement emerge as the patient regains the ability to smile, speak, and eat more normally.

Most people I photograph are acutely aware of their imperfections and try to minimize them. Some have confided in me that, in their attempt to look more normal, they strive for impassivity and repress their smiles. They worry that this effort is altering who they are emotionally and affecting how other people respond to them. While most of us assume that our expressions convey our emotions, it seems that the inverse can also be true: our emotions can, in some ways, be influenced by our facial expressions.

My intention has been to make portraits that are psychologically powerful, visually intriguing, and that challenge conventional notions of portraiture. When looking at someone with partial facial paralysis, we are in a sense seeing two versions of the same face at once, with each side conveying different emotions. Like gazing at a cubist painting, we observe multiple facets of someone in a single instant. As a visual artist, I find myself fascinated by the intensity of glimpsing two expressions simultaneously, a literal “two-facedness” that mesmerizes by its terrible beauty. At the same time, I hope these pictures bear witness to the incredible courage required to deal with medical afflictions, especially when they affect one’s primary appearance.  Even minor facial problems challenge and potentially diminish a person’s sense of self; the poise and inner strength that it takes to deal with this, while at the same time presenting oneself to the world, is remarkable. As I’ve listened to and photographed these people, I’ve been struck by how much complex feeling is revealed in their faces and gestures. Their brave self-presentation to the camera, at a time when they are most vulnerable and camera-shy, elicits something wistful, tender, and deeply human.