First Person: The therapeutic value of touch

photo by Jonas Vincent via unsplash.comThe first time one of my medical professionals touched me for comfort rather than during a physical exam, it was during my liver biopsy.  I was extremely frightened of the procedure, due to how painful I’d been warned the procedure was, and I was, and still am, slightly uncomfortable with needles (though daily Clexane shots sure sorts that out fast).  The medical team at the imaging clinic I attended had gotten in a second nurse, just to hold my hand during the procedure.  It was her 60th birthday, and she had been called in, literally, just to hold my hand.  I was incredibly moved by this, and incredibly comforted to have someone gently talk me through what was going on – to warn me to look away when the giant liver biopsy needle was brought out, helping me count holding my breath as the needle drew up the cancerous cells, and gently walking me to the recovery room after the procedure finished. It was one of the kindest things I have experienced with my medical professionals – and I have experienced more kindness than I can even recognise.

The path between comfortable physical contact and unwanted physical contact is something I imagine medical professionals find very difficult to navigate.  My nurses, GP, and oncology psychiatrist all hug me, sometimes at the end of each appointment, and sometimes just if they are not able to see me for some time, or if I am going away, or having a particularly challenging procedure.  These are all women, though, and women I have had a longstanding and quite profound relationship with.  When caring for someone with a complex illness, the relationship with the care staff who support the patient is profound and long lasting.

In regards to physical contact with male medical professionals though, I clearly remember a male ambulance attendant who came out on New Years Eve when I was having palpitations and light-headedness.  As we drove to the hospital, for my second ED visit in as many weeks, I struggled not to cry with frustration. He very gently stroked my arm, and I will always value that risk he took.  I wrote a letter, complimenting his incredible kindness to the ACT ambulance office.  But I think this comfort can still be offered by medical professionals who might not feel as comfortable touching a patient in other ways.  When I was in Rapid Assessment (the emergency area of the day therapy chemotherapy ward), again, near tears because I was so frustrated with the fevers I was getting, and the constant hospital visits, one of my regular male nurses offered to make me a hot milo. It was an exceptionally made hot milo, and that kindness was as generous as being hugged.

I have the added difficulty of my port for my chemotherapy infusions being located in my breast, due to having no other space to place it.  My nurses have no alternative than to be touching my breast, and often taping a bandage over my nipple each fortnight – and as a young (ish!) woman, they often apologise, or tread carefully.  This is something I also appreciate.  I offer to affix the further end of the bandage that attaches the port myself if they are apologetic, both for my own comfort (after a year and a half of chemo, I can do this in my sleep) and for theirs.  I also reassure doctors when needing to expose parts of myself that it doesn’t bother me; after having my liver removed from my body, and 28 rounds of pelvic radiation, and physical exams to attempt to locate my rectal tumour, I no longer consider doctors seeing any part of me as an undignified act.  But it is also their sensitivity towards understanding that this might be a concern that has gotten me to that point.   This, I imagine, may be something that concerns different age groups and different genders significantly, and the care and respect behind asking how best to handle this sort of medical touching seems really important to me, regardless of the age of the patient.

I can understand that perhaps it is best to tread carefully when making physical contact with patients; asking patients if they would like a hug, or if they would like their hand to be held during a procedure.  Those small kindnesses like offering to bring a visibly distressed patient a drink are also a gesture that indicate that the medical team understand that it is more than just antibiotics and chemotherapy and radiation – or whatever set of difficult treatments aimed at prolonging life comfortably for as long as possible – that help us keep going.

Elizabeth Caplice is an archivist on hiatus. She has Stage IV colorectal cancer, and writes about cancer, and how it intersects with life, particularly in younger adults. Elizabeth blogs at Sky Between Branches and can be found on Twitter.

As always please leave comments below.

4 thoughts on “First Person: The therapeutic value of touch

  1. By coincidence I was thinking about this recently… I was at work in the hospital on my ward round and we kept getting pages to come back to a particular dying patient as his family were very distressed. The patient’s wife did not speak English at all, but luckily for me my junior doctor spoke Cantonese and was able to interpret for me.
    We’d already spent time with the family that morning and explained things and answered questions as best we could. The first call back was because the family wanted the nurses to keep taking the patient’s observations (blood pressure, heart rate etc.) Again, I tried to explain that the observations didn’t help her husband, and we only wanted to do things that would help him. The second call back was because his face was flushed, and the third because his hands were cold.
    My junior doctor was patiently retranslating my words and it occurred to me (later than it would have perhaps, if the conversation had been in English and not via an interpreter?) that talking was not helping and I did something that I almost never do; I took the sobbing lady into my arms and gave her a huge hug. It seemed to remove the distance imposed by our different perspectives on what was happening, our different health literacy perhaps, and the barrier of not having a common language.
    There was a fourth call back – I can’t remember what for – and this time the wife reached out for me and we hugged again. Her husband died soon after.

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  2. Thank you for sharing your experience with us, Elizabeth. I’m very impressed by the imaging clinic who called in the nurse – kindness is so underrated in health care.

    I often hold a patient’s hand or stroke their forearm when breaking bad news, or in the terminal phase of illness. On reflection, I’m less likely to do this for a younger person, particularly a male patient. I’ve had older people tell me that I’m the first person to touch them for as long as they can remember (not including showering, assistance with mobility, etc).

    One the respondents to a tweet about this blog shared this link: http://drlj.me/2012/11/11/the-human-touch/ – it has links to further references on this topic if anyone would like to read further.

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    • that imaging clinic was amazingly supportive – i had the same doctor see me multiple times – the road to my diagnosis was long, complicated and traumatic – and this particular Radiologist suspected the tumours in my liver were cancer while the rest of my team said it was unlikely due to my general health. he talked me through the procedure, apologised when the biopsy briefly hurt (the sedation was very effective and i barely felt it, just slightly, and was more mildly amused by the sensation rather than bothered), and told me he wished me all the best. by the look on his face, and the fact he told me that we’d know what the tumours were in 48 hours, rather than the 2 weeks my other doctor had told me, i am guessing he recognised the cells instantly.

      i no longer need to go to that specific clinic (it doesn’t have an arrangement with my public hospital so i’d not be able to get bulk billed CT’s through there) and i only need him for ‘liver stuff’ because he’s the liver dude, but god, i would give that man a hug if i ever encounter him again. getting that nurse in was such an act of kindness.

      Liked by 1 person

  3. Wow. I came here because I was directed by an online blogger friend. As a young occupational therapy student and as someone who likes touch, this is important for me. I am so sorry that I came upon this blog late. Thank you, Elizabeth.

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