Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The sensory limitation of wearing masks

Hailey Amick, MD
Physician
June 28, 2020
99 Shares
Share
Tweet
Share

Without a doubt, life has been peculiar since the onset of the COVID-19 epidemic. The social, political, financial, and emotional tolls have been staggering; however, most recently, I’ve been interested in the sensory deficits it seems to be unmasking. Despite being back out in society, at work, or venturing into my children’s school, I have yet to resume seeing people’s faces. The world, as I know it, has become a moving body of masks and bandanas.

Though the eyes remain exposed, even these windows to the soul are rendered a bit more obscure without the context of the surrounding face. The other features seem critical for identification, communication of emotion, and social discernment, yet they are now effaced. In this new world of masks, there is an entire dialogue within our interactions to which we are now blind.

Working in an operating room setting where hats and masks are worn regularly, I am accustomed to this. Not seeing faces is routine, and there are colleagues I can pass in the grocery store to this day without recognizing. It never seemed unusual until those hats and masks disseminated into the preoperative area. Now I confuse my pre-op nurses, unless they are particularly tall or short. My airway assessment, a critical exam for an anesthesiologist, is hampered.

I need to be able to keep patients breathing after putting them to sleep, because no one lives long without oxygen. Part of my profession is thus scrutinizing people’s faces, searching for clues of impending difficulty. I look at the size of their mouths, how wide they open, the range of motion of the jaw. I look at their tongue size, the protrusion of their teeth, and the arch of their palate. I lay my hands on them, measuring their neck circumferences and thyro-mental distances. This exam is focused, and of course, the patients drop their masks for it; however, there are parts of the exam that are a matter of observation. Watching their faces move when they speak to me is part of the assessment, and it can now be lost in translation.

This phenomenon likely exists for everyone in different ways, but I wonder if it does so to an equal degree?

The sensory limitation of mask-wearing brings to mind a neurologic condition called prosopagnosia, or face blindness. It is typically congenital, although it can be the result of a stroke or injury in a part of the brain called the fusiform gyrus. Affected individuals can’t recognize faces and in written accounts, describe being unable to identify even close friends and family: children, spouses, or even themselves. The lack of facial recognition is especially poor if an individual is seen out of context. Often, these patients identify others by alternative features such as height, voice, prominent eyewear, or a distinctive nose. Jane Goodall is afflicted by prosopagnosia, as was the late Oliver Sacks, a renowned neurologist, and author. He wrote about his experiences and his patients with agnosia and other neurologic lesions in his book, The Man Who Mistook His Wife for a Hat.

Dr. Sacks wrote the following in an article published by The New Yorker,

“… Thus on several occasions, I have apologized for almost bumping into a large bearded man, only to realize that the large bearded man was myself in a mirror.”

Most of these patients adapt in various ways and are able to live functional lives, but they suffer socially. The condition is often familial and is thought to represent about two and a half percent of the population- which is to say, millions of people! Like most things, facial recognition ability exists on a bell curve. The prosopagnosics are on the left side of the curve, and there are those who exist on the far right, called “super-recognizers.” These individuals can recognize the face of nearly every person with whom they’ve ever come into contact, regardless of the context. They can often even recognize a person by seeing only a small portion of the face or the way he/she moves or walks.

Of course, the remainder of the population exists somewhere in the middle of the curve. Some are better than others at facial recognition, and some are quite poor. Many neurologists speculate that the incidence of prosopagnosia is higher if one accounts for a larger area on the left side of the curve. Milder forms likely exist and are under-reported or undetected as people simply accept that they are bad at remembering faces.

I suspect COVID, or the fact that we must wear masks in the setting of COVID, is making those differences in brain functioning more apparent. The masks are covering some things while revealing others about the way we see, interpret, and communicate with one another.

One of my patients complained to me yesterday that the masks have upset his dating life. “You never know what surprises are lurking underneath: Crooked teeth! Facial hair! Weird moles!”

I suggested this may be a better way to find a partner. After all, there are plenty of ugly things on a person’s insides, and those take much longer to discover than unfortunate birthmarks. He dismissed the idea. Perhaps he has a point. The fact remains that while they ought not to be the standard of true beauty, faces are important.

Hailey Amick is an anesthesiologist who blogs at Facing Monsters. 

Image credit: Shutterstock.com

Prev

In these times of crisis, remember the Golden Rule [PODCAST]

June 28, 2020 Kevin 0
…
Next

Should you get a COVID-19 antibody test?

June 28, 2020 Kevin 0
…

Tagged as: COVID, Infectious Disease

Post navigation

< Previous Post
In these times of crisis, remember the Golden Rule [PODCAST]
Next Post >
Should you get a COVID-19 antibody test?

More by Hailey Amick, MD

  • Anesthesia touches nearly every area of medicine

    Hailey Amick, MD
  • COVID: an impending case of the stripes

    Hailey Amick, MD

Related Posts

  • A physician’s addiction to social media

    Amanda Xi, MD
  • Dirt masks and couples massages: My trauma bonds in medical school

    Micaela Stevenson
  • How a physician keynote can highlight your conference

    Kevin Pho, MD
  • Chasing numbers contributes to physician burnout

    DrizzleMD
  • The black physician’s burden

    Naomi Tweyo Nkinsi
  • Why this physician supports Medicare for all

    Thad Salmon, MD

More in Physician

  • Physician entrepreneurs offer hope for burned out doctors

    Cindy Rubin, MD
  • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

    Elizabeth Cerceo, MD
  • Raw humanity on night float: inspiring patient encounters and overcoming challenges

    Johnathan Yao, MD, MPH
  • Revolutionizing emergency medicine: Overcoming long-term challenges with innovative solutions for physicians and patients

    Anonymous
  • The pediatric health care system tested to the limits: an inside look at the “at capacity” period during the tripledemic

    Jacqueline Bolt, MD
  • How chronic illness and disability are portrayed in media and the importance of daily choices for improved quality of life

    Juliet Morgan and Meghan Jobson
  • Most Popular

  • Past Week

    • A patient’s perspective on the diminishing relationship between doctors and patients

      Michele Luckenbaugh | Conditions
    • Unmasking wage disparity in health care: the truth behind the Elmhurst Hospital physician strike

      Kevin Pho, MD | KevinMD
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • How electronic health records preserve patients’ legacies in the words of oncologists

      Marc Braunstein, MD, PhD | Physician
    • Unmasking the brutal reality of gun violence in America: a call to action for unity and meaningful change

      Osmund Agbo, MD | Policy
  • Past 6 Months

    • The growing threat to transgender health care: implications for patients, providers, and trainees

      Carson Hartlage | Policy
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
  • Recent Posts

    • Physician entrepreneurs offer hope for burned out doctors

      Cindy Rubin, MD | Physician
    • Uncovering the truth about racial health inequities in America: a book review

      John Paul Mikhaiel, MD | Policy
    • Why electronic health records are failing patients: the dark side of copy and paste [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • The surprising medical mystery of a “good” Hitler: How a rescued kitten revealed a rare movement disorder

      Teresella Gondolo, MD | Conditions
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 1 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • 'Medically Relevant to Saving the Life of Your Patient': What We Heard This Week
  • Want to Solve the Nurse Shortage?
  • Why Are Female Doctors Sued Nearly Half as Often as Male Doctors?
  • What Drug Did FDA Just Approve for COVID?
  • PET Scan for Alzheimer's Dx; Predicting Colon Cancer Survival

Meeting Coverage

  • No Access to Routine Healthcare Biggest Barrier to HPV Vaccination
  • Trial Results Spark Talk of Curing More Metastatic Cervical Cancers
  • Cross-Border Collaboration Improves Survival in Pediatric Leukemia Patients
  • Monoclonal Antibody Reduced Need For Transfusions in Low-Risk MDS
  • Less-Invasive Surgery for Pancreatic Cancer Proves Safe, Effective
  • Most Popular

  • Past Week

    • A patient’s perspective on the diminishing relationship between doctors and patients

      Michele Luckenbaugh | Conditions
    • Unmasking wage disparity in health care: the truth behind the Elmhurst Hospital physician strike

      Kevin Pho, MD | KevinMD
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • How electronic health records preserve patients’ legacies in the words of oncologists

      Marc Braunstein, MD, PhD | Physician
    • Unmasking the brutal reality of gun violence in America: a call to action for unity and meaningful change

      Osmund Agbo, MD | Policy
  • Past 6 Months

    • The growing threat to transgender health care: implications for patients, providers, and trainees

      Carson Hartlage | Policy
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
  • Recent Posts

    • Physician entrepreneurs offer hope for burned out doctors

      Cindy Rubin, MD | Physician
    • Uncovering the truth about racial health inequities in America: a book review

      John Paul Mikhaiel, MD | Policy
    • Why electronic health records are failing patients: the dark side of copy and paste [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • The surprising medical mystery of a “good” Hitler: How a rescued kitten revealed a rare movement disorder

      Teresella Gondolo, MD | Conditions
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The sensory limitation of wearing masks
1 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...