Monday, January 11, 2010

TOUCH



I wrote in an earlier blog that a woman in a cancer patient support group complained, “When I was in the hospital I was poked and probed and ultraviolated, but I was never touched.”

In authentic, effective healthcare, touch is more than physical contact. As physician-author Abraham Verghese recently explained (http://content.healthaffairs.org/cgi/content/full/28/4/1177),

“I recall one patient who was, at that point, no more than a skeleton encased in shrinking skin, unable to speak, his mouth crusted with candida that was resistant to the usual medications. When he saw me on what turned out to be his last hours on earth, his hands moved as in slow motion, and as I wondered what he was up to, his stick fingers made theirway up to his pajama shirt, fumbling with his buttons. I realized that he was wanting to expose his wicker-basket chest to me: it was an offering, an invitation.

I didn’t decline. I percussed, palpated, and auscultated. I think he surely must have known by then that it was vital for me, just as it seemed necessary for him. Neither of us could skip this ritual, which had nothing to do with detecting rales in his lungs, or finding the gallop rhythm of heart failure.

No, this ritual was about the one message that physicians have needed to convey to their patients, although God knows, of late, in our hubris we seem to have forgotten, we seem to have drifted away, as if with the explosion of knowledge, the whole human genome mapped out at our feet, we are lulled into forgetting that the ritual is cathartic to the physician and necessary for the patient, forgetting that the ritual has meaning and a singular message to convey to the patient. And the message,which I didn’t fully understand then, even as I delivered it, and which I understand better now, is this: I will always, always be there, I will see you through this, I will never abandon you, I will be with you through the end.”

Wish I’d written that. Thanks, Abe, and thanks to my two doc friends who simultaneously forwarded the essay to me.

No comments:

Post a Comment