From Chicken Soup for the Volunteer's Soul

The Sounds of Hope

Hope is the thing with feathers that perches in the soul, and sings the tune without the words, and never stops, at all.

Emily Dickinson

Regilene, a petite, shapely woman with long, thick, mocha-colored hair, moved with the slow, swaying style of women born to samba—the Brazilian dance of sensual hip gyrations. Her cinnamon skin and large, dark eyes seemed weary from twenty-seven years of negotiating a hard life.

When she first entered my exam room at the mission, her right hand was gently cupped over the center of her face. As she carefully removed that safeguard, her delicate fingers fell to her side revealing a sight that would provoke a wince, even in someone accustomed to working with maxillofacial disorders. Regilene had no mouth or nose, only a gaping hole where nature had played an evil trick, causing her palate and teeth to protrude from the chasm in a hideous countenance.

The plastic surgeons, nurses and dentists had already examined her. As a speech pathologist, I was familiar with cleft-palate speech and fluent enough in Portuguese to complete an evaluation and make an analysis as to how surgery might affect her speech.

I noted from her medical record that she was a young woman who lived in the interior of Brazil, a five-hour bus ride away. The fact that she was an adult was disturbing. The mission was based in a pediatric hospital, which meant that we only took children under the age of sixteen.

Oi, Regilene, como vai?” I asked, as she sat down in my patient chair. “Hi, how are you?” The edges of her eyes turned up in what appeared to be a smile.

She produced a picture of a cherubic little boy. “Meu filho” (“My son”), she explained. Her nasal speech was intelligible only to those accustomed to cleft-palate conversation. She continued in Portuguese, using hand signals and gestures. “He was watching television and saw that Operation Smile was in this city. He begged me to come and get my face fixed. I am here for him and for me.”

That night, after the team meeting, I searched for Dr. Bill Magee, the head of our mission and founder of Operation Smile. I wanted to be sure we would not turn this lady away. Surely we could do something for her.

To my relief, Dr. Magee had already sized up the situation and was working fervently with two Brazilian plastic surgeons and the hospital administration. Time was running out. We would be leaving in five days.

All week Regilene waited as a hundred children came and went, and returned for follow-up visits. Regilene, accompanied by a cousin, stayed in a crowded dorm-like room attached to the hospital.

In the middle of the week, I helped the team’s Brazilian dentist fashion an obturator for Regilene—a dental prosthesis that would help close off the hole in her palate, improving her ability to eat and perhaps even her speech. My colleagues and I taught her oral-motor exercises and showed her how to use her tongue and newly created palate to sound out letters. She practiced and wore her obturator faithfully. But the device failed to improve her appearance, and we were well aware it wasn’t what she had come for.

While her cousin was away for a week, I looked in on Regilene every day. I usually found her among the children, drawing pictures of smiling girls with perfect faces. I brought inexpensive trinkets, like necklaces, lotion and bubbles, to keep her spirits up. Marc, the team photographer, gave her the most cherished gift of all: a radio headset to help her pass the time. All she could do for five interminable days was wait and hope.

Finally on the last day, the surgeons announced that they would operate. She was to be the last patient of the day. I reassured an anxious Regilene that I would accompany her into the operating room and hold her hand as she was put to sleep.

As promised, I spoke to her softly in Portuguese as the anesthesia took effect. I stayed for a while to watch the plastic surgeon, Dr. Henrique, as he created her new face. All I could see was a jumble of skin, cartilage, blood and teeth. It looked like a puzzle with missing pieces.

For the next few hours, I helped with the other patients in the recovery room, trying not to hope for too much. Suddenly, a voice summoned me from my reverie, “She’s almost finished in surgery, Cathy.”

I hurriedly put on my surgical mask, entered the room and carefully approached the sterile field. Dr. Henrique had just finished the last stitch. As I looked down, I saw an incredible sight. Where a horrendous abyss had once cursed Regilene’s face, there was the semblance of a normal nose and mouth that would soon be capable of forming a real smile. Tears soaked my mask. Every one of the nurses and doctors shed tears of joy. For a full minute we just stood there in awe.

I sat with Regilene in the recovery room, as she slowly came to. With fear-filled eyes she took my hand. Later, a nurse and I wheeled Regilene out into the hallway to be taken to the post-operative area. Waiting at the end of the corridor were her cousin and the rest of the Operation Smile team. It seemed Regilene’s timing was impeccable. Team members were already packing instruments for their return to the United States.

When Regilene appeared, everyone applauded and the sounds of hope echoed through the halls. As the nurse wheeled the cart toward the door, Regilene’s cousin suddenly blocked their path, crying and yelling “Pare!” (“Stop!”). Next, she ran over to me, hugged me and said in Portuguese, “This is a miracle from God! Thanks to all of you for helping my Regilene.” The cousin and the cart disappeared around the bend. I stood there, my body drained but my soul full.

Cathryn Pearse Snyders

[EDITORS’ NOTE: For information on Operation Smile, contact 6435 Tidewater Drive, Norfolk, VA 23509; 757-321-7645; fax:757-321-7660; Web site:]

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