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Smiley Faces Foundation: Promoting Awareness And Amazing Kids

We live in a society obsessed with outside beauty, so it’s no wonder that parents whose children are born with any imperfection worry endlessly about how their child will be accepted in society.

As parents, though, our job is to make sure our kids see themselves as much more than whatever obstacles are tossed their way, as tough as that may be.

Adam and Donna Bell felt that anguish first hand in 2005 when their son Ethan was born with cleft lip and palate. Ethan now has an adorable smile and hardly a scar at all thanks to the amazingly talented doctors at the NYU Institute of Reconstructive Plastic Surgery.

Wanting to do more to raise awareness about the nearly 1 in 600 infants born with cleft (opening) lip or palate each year, the Bell’s founded Smiley Faces Foundation, a nonprofit who strives to not only assist the Institute of Reconstructive Plastic Surgery at NYU Langone Medical Center, but also help provide treatment for all children who need cleft lip and palate repair in the United States.

As the Bell’s know first hand, the road from complicated defect to picture perfect smile is a long one with many emotional and financial hurdles for the family and painful surgeries for the child. One of the goals of the foundation is to help families financially and make sure children in need of care, get the care.

The Bells wanted to do more, though. They wanted to help these families help their kids not become defined by the long process of repair and not become defined by their scar. They also wanted to give a message to society that their kids are beautiful despite the scar. Out of this concept rose the foundation’s first gala event with the children being highlighted by the world’s top photographers to display their amazing smiles and unique beauty.

All tolled, 22 children were photographed by 21 of the world’s top photographers whose pictures [were] displayed at Smiley Face Foundation’s first gala on April 27 at Red Bull Space in SoHo, NY. You can get more information on this event at

Nigel Barker was one of the photographers who donated his time and talent to this remarkable event. Nigel photographed a tween girl named Natasha whose repair was done many years ago when she was an infant.

I had the opportunity to talk with Nigel last week about his experience taking Natasha’s picture and why this cause was important to him. Here’s a snapshot of my conversation with Nigel:

Why did you decided to get involved with Smiley Faces Foundation?

First and foremost I always feel that if something needs to be done, if I can raise awareness, I would obviously get involved.

Having my own children I’m acutely aware of what parents go through with children of any problem and truly feel for them. With my work with other groups like Make a Wish and the Elizabeth Glazer Pediatric Aids Foundation as a Celebrity Ambassador I try to use my celebrity from Top Model to give back and make a difference in these kids’ lives.

Why this project?

Pictures convince people by showing them there is hope when they thought there was none and it’s truly my honor to help accomplish that. It’s useful for charities to engage people like me so people can view the images and make their minds up for themselves.

The photo shoots tend to be more amazing for the parents than the child oftentimes. Natasha had 7 or 8 relatives with her who were often very teary eyed.

Did the family seem to have a tougher time than Natasha?

Definitely. For sure. You could sense it was very, very difficult. The child had to endure the many painful surgeries but the family had to endure getting the child to this point.

Did Natasha carry any of her problems into the room at all?

Natasha didn’t carry her issues into the shoot with her at all which is a testament to her parents and doctors. I saw the before pictures and they were difficult to see. Having only a teeny scar now is remarkable.

What was Natasha like to work with? From her pictures, she seemed like a truly outgoing, energetic tween to me.

Natasha was charismatic, lively, charming and truly acting like a pro. We had great fun! She had all the qualities I like to see when we judge beauty!

Any surprises?

I was pleasantly surprised by how natural she was in front of the camera and with all of us. For an 11, 12 year old in braces  (at that awkward age) that’s remarkable. She was bouncing around, giving us moves. It was like she had studied Top Model!

Did you take away anything from this experience as a parent?

As a parent, I try to be a sponge and never cease to be surprised by the strength of these people, the kids. I often get teary eyed myself – I’m a big softy.

I always try to encourage people to see kids as more than their scars or medical conditions. I don’t see those things at all, although perhaps it’s because I’m a doc. What’s your view on beauty when kids have scars?

We are the sum of our imperfections, and that’s what makes us unique and beautiful – and makes us our story to tell.


Annette Orlando Figueiredo, Natasha’s mom, summarized the shoot like this: “I will never forget when she skipped to the changing room, saying,”mommy, I feel so beautiful” I wanted to cry because she never said anything like that before. We will both thank Adam and Nigel for making her feel that way forever. What an experience of a lifetime.”

Nigel said it best when he noted that “we are the sum of our imperfections and that’s what makes us unique and beautiful”. Now 22 kids have been given that gift and can see themselves as the sum of much more than any one blip or bloop that they experience in their lives.

More for the families than the kids, though, an experience like the one these photographers have provided helps these families heal from a very painful chapter and move to a brighter future filled with many more uplifting images than disturbing and frightening ones. That’s the power of a photograph and something words can not accomplish.

Since a picture tells a thousand words, I’ll let Nigel’s pictures of Natasha tell you everything you need to know about the gift he gave her — and about the gift her smile will give to you:

See what I mean?

*This blog post was originally published at Dr. Gwenn Is In*

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Richmond, VA – In an effort to simplify inpatient medical billing, one area hospitalist group has determined that “altered mental status” (ICD-9 780.97) is the most efficient code for use in any patient work up.

“When you enter a hospital, you’re bound to have some kind of mental status change,” said Dr. Fishbinder, co-partner of Area Hospitalists, PLLC. “Whether it’s confusion about where your room is located in relationship to the visitor’s parking structure, frustration with being woken up every hour or two to check your vital signs, or just plain old fatigue from being sick, you are not thinking as clearly as before you were admitted. And that’s all the justification we need to order anything from drug and toxin screens, to blood cultures, brain MRIs, tagged red blood cell nuclear scans, or cardiac Holter monitoring. There really is no limit to what we can pursue with our tests.”

Common causes of mental status changes in the elderly include medicine-induced cognitive side effects, disorientation due to disruption in daily routines, age-related memory impairment, and urinary tract infections.

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Another nurse reports that delay in diagnosing urinary tract infections (while patients are scheduled for brain MRIs, nuclear scans, and biopsies) can lead to worsening symptoms which accelerate and expand testing. “Some of my patients are transferred to the ICU during the altered mental status work up,” states nurse Anita Misra. “The doctors seem to be very excited about the additional technology available to them in the intensive care setting. Between the central line placement, arterial blood gasses, and vast array of IV fluid and medication options, urosepsis is really an excellent entré into a whole new level of care.”

“As far as medicine-induced mental status changes are concerned,” added Dr. Fishbinder, “We’ve never seen a single case in the past 10 years. Today’s patients are incredibly resilient and can tolerate mixes of opioids, anti-depressants, anti-histamines, and benzodiazepines without any difficulty. We know this because most patients have been prescribed these cocktails and have been taking them for years.”

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As for the nursing staff, Griffiths offered a less glowing review. “It’s unfortunate that our nurses seem preoccupied with urine testing and medication reconciliation. I think it might be time for us to mandate further training to help them appreciate more of the medical nuances inherent in quality patient care.”

Dr. Fishbinder is in the process of creating a half-day seminar on ‘altered mental status in the inpatient setting,’ offering CME credits to physicians who enroll. Richmond Medical Hospital intends to sponsor Dr. Fishbinder’s course, and franchise it to other hospitals in the state, and ultimately nationally.


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