In the origin story of Dr Smiley Creepypasta, several elements stand out. Firstly, his profession as a doctor is central. It provides a backdrop for his supposed unethical actions. The hospital environment, often described as dark, run - down, and filled with an oppressive atmosphere, is another key factor. His smile, which is not a normal friendly smile but rather a twisted and menacing one, is what really defines him. This smile is what gives him his name and is a constant reminder of his malevolence. Additionally, there could be underlying themes of madness or a thirst for power that are hinted at in the origin story, which help to further develop his character as a terrifying Creepypasta figure.
One key element is his identity as a doctor. Another is the spooky hospital setting. And of course, his menacing smile.