Learn Hardcore Dutch: De patiënt glimlacht alsof de pijn helemaal weg is. - The patient smiles as if the pain is completely gone.

Alsof means as if / as though and introduces a subordinate clause describing an appearance, comparison, or pretense. In De patiënt glimlacht alsof de pijn helemaal weg is, it links the manner of smiling to the hypothetical state that the pain is completely gone. Common patterns:

After verbs of manner/appearance: Hij glimlacht alsof alles goed is.
With pretending: Hij doet alsof hij ziek is.
With seeming: Het lijkt alsof het gaat regenen.

Why is is at the very end of alsof de pijn helemaal weg is?

Because alsof introduces a subordinate clause, and in Dutch subordinate clauses the finite verb goes to the end. Compare:

Main clause order: De pijn is helemaal weg.
Subordinate order: … alsof de pijn helemaal weg is.

Do I need a comma before alsof?

Often you don’t. A comma is optional when the alsof-clause follows the main clause. Without a comma the link is tight and neutral: De patiënt glimlacht alsof …. With a comma it can feel a bit more parenthetical or afterthought-like: De patiënt glimlacht, alsof …. Both are acceptable; choose a comma if it aids readability.

Can I use zoals or als instead of alsof?

No. Alsof = as if/as though (hypothetical). Zoals = like/as (real comparison: Hij lacht zoals een kind). Als is if/when, or used in comparatives (zo … als). So stick with alsof here.

Can I use past tense after alsof (e.g., was) or even zou zijn?

Yes. All three occur, with nuance:

… alsof de pijn helemaal weg is: simultaneous and possibly real/neutral.
… alsof de pijn helemaal weg was: more hypothetical, often implying it isn’t actually gone.
… alsof de pijn helemaal weg zou zijn: explicitly hypothetical/conditional; a bit heavier in tone.

Why de pijn and not zijn/haar pijn?

Dutch often uses the definite article for body parts and sensations when the possessor is clear from context. Here de pijn naturally refers to the patient’s pain. Zijn/haar pijn is possible for emphasis or contrast, but de pijn is the default and most idiomatic.

What is weg here—does it mean “road”?

Here weg means gone/away, functioning as a predicative adjective/adverb: De pijn is weg. The noun de weg means the road, but that’s a different word class and meaning. Note that weg is not used attributively for pain: you don’t say de wegge pijn.

What’s the nuance of helemaal? Could I use volledig or compleet?

Helemaal means completely/entirely and is very idiomatic here: helemaal weg. Volledig or compleet are possible but sound more formal or less natural with weg; you’ll more often see volledig verdwenen or compleet pijnvrij. Alternatives:

De pijn is over (the pain is over).
De pijn is verdwenen (the pain has disappeared; more formal).

How do I conjugate glimlachen, and how is it different from lachen?

Present: ik glimlach, jij/hij glimlacht, wij glimlachen
Past: ik/jij/hij glimlachte, wij glimlachten
Perfect: heeft geglimlacht Glimlachen = to smile (quietly, without sound). Lachen = to laugh (often audible). Related: grijnzen = to grin (can be sly/negative).

Is alsof one word? Do I ever add dat after it?

It’s one word: alsof. Don’t write als of. In Standard Dutch you don’t add dat: alsof de pijn weg is, not alsof dat de pijn weg is. You may hear alsof dat regionally (e.g., in parts of Flanders), but it’s not standard.

Can I put the alsof-clause first?

Yes, for emphasis or style:

Alsof de pijn helemaal weg is, glimlacht de patiënt. When a subordinate clause comes first, the finite verb in the following main clause still comes before the subject (glimlacht de patiënt) due to Dutch verb-second word order.

Any pronunciation tips for the tricky parts?

Approximate IPA (Netherlands Dutch): [də paːtiˈɛnt ɣˈlɪm.lɑxt ɑlˈsɔf də pɛi̯n ˌheːləˈmaːl ʋɛx ɪs]

patiënt: stress on the last syllable; ï shows a syllable break (pa-ti-ënt), not a long ie.
g/ch in glimlacht: guttural fricatives; g is usually voiced [ɣ], ch is voiceless .
ij in pijn: diphthong [ɛi̯] (near English eye but starting more open).
w in weg: approximant [ʋ], not the English w.

Why does patiënt have a diaeresis (the dots on ï), and is it mandatory?

Yes, it’s required. The diaeresis (trema) marks that the i starts a new syllable, preventing tie from being read as a single vowel sound. So it’s pa-ti-ënt, not pa-tient.

Is pijn countable? Could I say een pijn?

Pijn is typically uncountable. You say pijn hebben (to have pain) or refer to de pijn in context. Countable uses are rare and occur mostly in set phrases or compounds (pijnscheut = stab of pain), not as een pijn in everyday speech.