she steps in quietly - back straight - almost unnaturally so with the neck tilted slightly forward. her eyes quickly take in the room as her smile remains ready for a polite and effusive hello. her hair is short and her clothes are simple faded jeans and a white cotton shirt. at first glance she appears carefree and confidently masculine, but as i look closer i notice the expertly blended highlights in her blond hair - the carefully placed side swept bangs just covering her aging forehead. i notice how the loose shirt has a little tie at the collarbone - painstakingly creating a perfect bow and the waistline is arranged in just the right way to disguise extra weight she has collected through the years. she was beautiful once, i think, and she still feels beautiful when the flaws are discreetly hidden. her expectant look says she is accustomed to being admired - and then she remembers the extra weight and wrinkled forehead and sagging breasts and the smile dims - only momentarily. her head lifts higher - her chin thrusts out defiantly as she steps forward. her manner is calm until i notice her hands - worn but strong and at first giving the impression of courage and noble devotion to hard work. but a closer look discovers the gnawed cuticles and skin picked relentlessly when the calm facade cannot completely hide the searching mind. if i continue to watch the hands will come together to pull at a ragged bit of skin or scratch the frequent itch on the inside of the fingers. she is known in the community for her good deeds - a home cooked meal for the new mother down the block - another collection for the poor - friendly acknowledgement for the cashier at the acme and the pharmacy and the little town library - unwavering commitment to her family. most would never guess the restlessness revealed by her fingernails or the weariness that flickers unexpectedly behind her smile. she is from a culture where the smile is always in place and even in therapy all those years ago she usually walked in with a smile that only dissolved when her face crumbled with tears. but that is in the past. she is in the room now with the smile looking genuine and the hands quiet - the expectancy having passed as she settles into a chair and watches life from a distance.