In “Smile: The Story of a Face” (Simon and Schuster, 256 pages), Sarah Ruhl recounts how, at the same time that her first play was about to open on Broadway, and she was about to give birth to twins, she experienced a series of exasperating diseases, most centrally Bell’s palsy, which paralyzed the left side of her face, making her unable to smile.

The condition usually lasts no more than a few months, but for some it’s permanent – not life threatening, but, on the evidence of this memoir, life consuming.

“I’ve always thought tell-all memoirs were sort of the last refuge of bad taste,” Ruhl writes at one point, “and preferred Montaigne (discursive reflections) to Augustine (self-revelation.)” Her memoir is a hybrid of the two.

She chronicles her efforts to treat her condition over the course of a decade, with visits to specialists of various levels of kindness and creepiness, and catalogues the effect the condition had on her physically, emotionally, spiritually, and from day to day.   She was reluctant to show her face to the first friend she saw after her condition kicked in, because she was embarrassed, but “I also felt bad that he had to come up with something to say. There is no Hallmark card for disfigurement.”

Her ear for dialogue (and her obvious habit of journal-keeping) enlivens the narrative with pages of verbatim conversations, such as the time a stranger asks her the names of her babies, and her facial  paralysis makes it difficult for her to pronounce her daughter’s name, Hope.

“Excuse me, I don’t think I heard you right. William and – Ho?”
“Ho-pe,” I said, sounding like I’d had a stroke.
“Ho?”
I spelled and yelled “H-O-P-E! Like the feeling?”
“Oh, Hope!”
“Yes!” I yelled, wanting to smile at the absurdity of the situation (that’s right, I named my twin babies ho and pimp), but I couldn’t.

At the same time, she riffs on the history, the science, and the cultural meaning of the smile and more generally of the face. Sometimes she offers a feminist spin. Men, even (especially?) strangers, are always telling women to smile; women rarely do so with men.  In high school, she tells us, the yearbook photographer told the girls to tilt their heads and smile, but didn’t tell the boys to do that. She then observes that “the tilt of the head, in evolutionary circles, indicates submission.” Also: “the girls, whether they knew it or not, were trying to produce Duchenne smiles,” a smile that includes the eyes and is an authentic expression of happiness. She explains that “The Duchenne smile is named after Guillaume Duchenne who studied facial expressions by mapping the faces of inmates at mental hospitals in the nineteenth century.” This concept of authentic expression leads her to a question: “Does the smile itself create the happiness? Or does the happiness create the smile?”

She offers a list of smiling idioms, that indicates its importance in our culture, such as “smile and the whole world smiles with you,” and analyzes such expressions as “shame-faced,” which tells us that “the face telegraphs shame…I was ashamed of the very instrument that was supposed to express shame…”

This pairing of revelation and reflection (anecdote and analysis) is sometimes erudite and illuminating; sometimes funny; sometimes just silly. So, as part of her facial exercises, she tells us how she watched old Marlon Brando movies to practice imitating the expressive way Brando moves his eyebrows, but then segues into the dubious observation that dogs are incomparably adorable because they have eyebrows, while cats don’t and thus aren’t.

I had eagerly sought out “Smile: The Story of a Face,” because I have so enjoyed Ruhl’s writing – yes, the plays I have seen of hers (“Stage Kiss,” “The Oldest Boy,” “How to Transcend a Happy Marriage” ) but in particular her book “100 Essays I Don’t Have Time to Write: On Umbrellas and Sword Fights, Parades and Dogs, Fire Alarms, Children, and Theater. ” Scattershot by design, these essays were full of wit and insight — her observations pithy enough, I exulted (at length), that had they been a series of Tweets, they might have gone viral.

“Smile,” too, has wit and insight. But it also feels overlong and surprisingly scattershot for what implicitly promises to be a coherent story. Two moments late in the memoir crystallized the reaction I had been slow and reluctant to acknowledge.

She recounts her meeting with Jonathan Kalb, a writer who also has chronic Bell’s palsy, and wrote about it for the New Yorker, in an article entitled “Give Me A Smile.” My first thought, which made me feel disloyal: Maybe a magazine article is the better length for this topic.

Later, on advice of a friend who is a neurologist, Ruhl writes (and shares with us) a list of the things for which she’s grateful, and concludes: “Suddenly, my half-smile problem seems so small, so very small.”

It’s possible that, by the time this memoir is officially published in October, 2021, the COVID-19 pandemic will have receded sufficiently so that the timing will seem more appropriate. Reading it right now, I started to feel after a while that her condition, which she concedes is “disappointing,” not “tragic,” grew smaller and smaller with each new redundant visit to a neurologist or physical therapist or acupuncturist, with each further lesson on the deeper meaning of her condition (even as she approvingly quotes Susan Sontag about the dangers of seeking meaning in illness.) 

This is not to dismiss the usefulness that this book might prove to those who live with any of her illnesses (among them also cholestasis of the liver during pregnancy, celiac disease,  and postpartum depression) or who suffer from an analogous chronic condition. 

But what salvages this book for me, perhaps ironically, is precisely her scattershot approach, because, while it makes the central story of her illnesses a bit of a slog, it also allows for plenty of digressions, including the sort of material that would be the meat of a more conventional memoir by a playwright.

She explains her approach to playwriting (which I think helps explain the existence of this book): “From the time I started writing plays I was interested in how to make theatrical the small, quiet moments – the sort that appear more frequently in a poem or a story.” She tells us how her writing of “The Oldest Boy” came from a story told by her nanny, a Tibetan Buddhist, and how it led her to seek refuge in Buddhism. 

We learn that after the success of her Broadway play, “In the Next Room or The Vibrator Play,” she decided she would no longer write about ingénues. Rather, “a wild ambition started to take root”: Every play she would write from now on would focus on a woman in a different decade of her life.  (She doesn’t tell us whether this was a momentary fantasy, or she’s actually started to write these plays.)

There’s her reminiscences of her heroic mentor Paula Vogel (also praised in the last playwright’s memoir I read, “My Broken Language,” by Quiara Alegría Hudes. Is it time for Vogel herself to write a memoir?) There is, in contrast, an unflattering anecdote about Edward Albee.

There’s the way she slips in a reference to theater even when discussing a scientific concept like  mirror neurons, the mechanism in the brain by which you yawn because somebody else has just yawned. “Some argue that mirror neurons are actually the neurological basis for empathy. The theater is all about mirror neurons; we watch actors feel, and we feel what they are feeling. “

Some of the most rewarding passages depict the delight she takes in her family, and this offers what may be the most valuable lesson of “Smile,” at least for theater lovers – that a harried married mother of three small children, who must deal with a worrisome series of illnesses, can be a professional playwright who writes play after play after play.