Friday, August 23, 2013

On Touching

Touching has always been a way to express our love and humanity.  Its ability to heal has been recognized since physicians made house calls in caves.  

Royalty has used it to great advantage too, knighting with touches of the hand and sword.  Moreover, the "royal touch" of British and French monarchs, which was believed to cure a glandular form of tuberculosis, enhanced their position as purveyors of divine power for many centuries.

There is still plenty of touching in the 21st century but the practice is somewhat on hard times.  I am reminded of one of my patients, a grade school teacher, who was terminated after hugging a child who had fallen and scrapped her knee on the playground.  My patient was ultimately pushed out of the school district by parents and administrators who couldn't see the difference between compassion (which it was) and perversion.

The workplace is now largely free (you can thank Anita Hill) of unwanted gropings and touchings.

But at a price.

Fear of  sexual harassment is so widespread at work  that  tearful and overwhelmed individuals must oftentimes soldier on without the immense benefit of a pat on the shoulder or a discreet hug from a colleague.

In medicine, touch remains  one of physicians most powerful tools.  

I remember a woman on a rehabilitation unit who had unmanageable pain.  She was in great distress and the staff and I were at wits end.  Finally  I recalled an article suggesting that severe pain could be relieved by hair brushing.  After getting myself and the nursing staff to buy into the idea that this kind of touching could relieve severe pain, I ordered hair brushing for ten minutes every six hours, scheduling the brushing just like a pain pill.  The results were astonishingly good.

Doctors have many different ways of comforting patients utilizing touch.  In my case,  I placed my free hand on their right shoulder while examining various organ systems.  My belief is that this practice created a connection between us that was strong, resilient and therapeutic.

The smart physician can sometimes diagnose and treat patients effectively without ever touching or examining them.

The wise physician knows that the addition of a perfunctory physical exam (say aah) in such cases can result in speedier and more durable cures.

Placebos remain one of doctors most powerful tools and touch is arguably its quintessence.


  1. "Touch is arguably its quintessence". Yes, it is too bad that physicians have, to a degree, delegated the healing touch -the laying of hands- to other health care professionals (nurses, alternative health gurus). Touch, being an element of humanness, can be an antidote to the more technical aspects of medicine.

    1. Cha Sen is a poet which reminds me of how deeply we can touch patients with words too.