I Wanna Hold Your Hand
Kendra Campbell -- A few weeks ago, I had an experience that has really stuck in my head. The resident and I were performing a painful procedure on a patient, and I could tell that he was really enduring a lot of pain by the grimace on his face. As I’ve done in the past, I instinctively reached out my hand and held his hand in mine. I allowed him to grip my fingers, and told him to squeeze my hand as hard as he needed to.
He started squeezing my fingers, and suddenly his face turned from a grimace to a smile. The change was rather startling, and so I jokingly told him that I’d never seen a patient with such a huge grin on their face while undergoing such a painful procedure. He smiled even more and said that it was because he was so happy to hold such a “pretty girl’s” hand. I smiled back, and soon the procedure was over.
I think it probably makes common sense that hand holding might bring some relief from pain. We all reflexively hold a child’s hand when they’re in pain. And I believe that even the most callous people might agree that there is something powerful about the human touch. Hugs are an even better example. I don’t know when the hug was invented, but I’m sure that it’s been around for quite some time. People of all races, ethnicities, and cultures seem to use the hug as a means of displaying affection. And while certain cultures might value human touch to varying degrees, I think we all agree on its significance.
One of the most well known studies on the power of touch and the importance of physical and social interaction is that of Harry Harlow. In his famous experiments, he allowed rhesus monkeys to choose either a cloth or wire ”surrogate mother,” both with and without a bottle of milk attached. Regardless of which mother had the bottle, the monkeys continued to choose the softer, cloth mothers. He also performed other controversial experiments, including ones where he deprived the monkeys of all physical or social interaction. The lack of physical touch produced monkeys with severe psychological pathologies, and in a few cases led to their deaths from self-induced starvation.
A study recently published in the journal Science also found some interesting results with regard to “warm hands and a warm heart.” The researchers found that if people were given something warm to hold, they subsequently described other people as having “warmer” personality traits, such as being more generous, more social, happier, and better natured. They also discovered that people who held something warm were more likely to behave in a friendly and generous way.
I’ve only begun to scratch the surface of the importance of the human touch, but you can see that the subject is much more than simply skin deep (pun intended). I tried to find some research that supports my anecdotal notion that holding someone’s hand who is in pain can serve to decrease their perception of the pain, but I was unable to find much research on this topic. Perhaps it’s a topic that will be further explored in the future.
But for the time being, I will continue to hold my patients’ hands. Whether they are in pain, or just very sad, or just very lonely, or even just very happy, I will continue to offer my hands to them. And hopefully when I need a hand to hold, someone will do the same for me.
What a great blog, thank you! I am an RN now going through my first year of medical school and I cannot tell you how much this type of empathetic gesture means to patients. In nursing school we are taught how to use our "presence" as a therapeutic measure and I wish that this was also stressed in medical education. An encouraging smile, a touch of your hand or being willing to just sit quietly with a dying patient are all valuable therapeutic techniques. At the end of the day birth, life and death can be scary and lonely and the "presence" of someone who really cares about your well-being can make all the difference! I am regular reader of your posts and its is really encouraging to know that there will soon be fine, caring doctors like you in the field!
Posted by: Amy | Nov 13, 2008 12:59:08 PM
It is well known that the first contact a newborn has with it's mother is through touch even before (he/she/it?) opens (his/her/it's) eyes. The way the baby is comforted, the way it forms the bond with the mother, breastfeeding, caressing.. I am not surprised that this sense of all the senses would have the greatest effect on patients. + even chimps hug...
Conclusion : I need a hug :(
Posted by: Tamim F. | Nov 15, 2008 12:25:07 PM
That's realy perfect tip :) And I've mentioned that some manipulations (auscultation, percussion, palpation etc.) provoke positive emotions in patients too...
Posted by: Alex | Nov 16, 2008 6:14:37 AM
Perfect. "The healing power of the physican's touch."
Posted by: tfb | Nov 17, 2008 8:16:48 AM
That's interesting, but not unexpected. People can endure hardships more easily when they feel they aren't alone. Your approach will probably be effective for a female physician with both male and female patients. For a male physician, most of the time it would be awkward (for both parties) with a male patient and there could potentially be undesirable sexual overtones with a female patient. I think your basic premise is very good, but male physicians will need to find another way to empathize with their patients than to hold their hands.
Posted by: Jon | Nov 18, 2008 2:57:49 PM
I think your commentary is very reassuring to hear as someone outside established medical circles. I am not in medical school. I work as medical interpreter and am studying somatic therapy techniques. As a massage student in science-based curriculum, one of the most interesting ongoing discussions has been by chiropractor who teaches our A&P class. She has talked at least once a week about the positive effects MT has upon ANS, especially in light of cultural tendency towards adrenaline-depletion and chronic digestive issues as result of people unable to activate "rest & digest" processes. I think it's great you're willing and able to extend power of touch into your developing practical skills. I'm sure you'll be a better medical professional because of it! =>
Posted by: Leuth | Nov 18, 2008 6:59:47 PM
I personally experienced a childhood with limited resouces for nurturing. I make it a practice everyday while I'm working in the O.R. to comfort a patient. Thank you, to all of you, who do what you do!
Posted by: Melody | Nov 19, 2008 6:00:42 AM
Great post Kendra. Sometimes, holding someone's hand is about all that you can do.
And I disagree with Jon, although I understand his concerns. Trust me, it's good for a male doctor to hold a patient's hand or touch their arm or even reach out and hug them.
Posted by: Ann Rhys-Matthews | Nov 19, 2008 6:51:27 AM
Kendra, great post! And Ann, you are spot-on with your comment! I have been a massage therapist since 1985 and have also spent the past couple of years as a respiratory therapist, in preparation for entering physician assistant program (I start this January!)I am currently employed locally to give complimentary short massage to inpatients (yes, even ICU/PCU), staff, longterm care, and cancer support clinic... with amazing response from everyone. Every day I watch stressed, hunched, SOB pts melt and slow down their breathing as I just gently massage hands, forearms or maybe lightly squeeze top of shoulders. They feel they are not forgotten. My own DO significantly affected my healing when I first met him in the midst of a medical crisis, and he said "Oh, you need a hug". The fact that he would cross that barrier to comfort me made all the difference in my willingness to trust him and follow his advice. But from a scientific standpoint there is unquestionably a body-mind correlation. Appropriate touch indicates to patients that we are truly present in that moment with them, and helps bridge the isolation and fear of not being important that pts often experience. Kendra, I could and probably will explore this for my master's project later on... but I am definitely bringing my massage table to med school and will give to my stressed out peers, while also imparting my experience of how touch is essential in the healing process.
Posted by: Sunshine McWhinney | Nov 19, 2008 7:21:21 AM
I am not a physician, but a personal trainer. I always ask clients if it is okay to touch them first. There are many people who have physical or sexual abuse issues. If I absolutely have to touch a client during a specific work-out, I tell them first.
If you are a male clinician you can address the contact issue easier if you simply ask or inform first. I can understand that there are people that are tactile defensive and those that may perceive your touch as sexually inappropriate whether they be male or female. The solution is to ask.
Example: "Would you like to hold my hand?" "You seem like your are in a lot of pain, is it ok for me to place my hand on your shoulder?" "During this procedure I will need to place my hand on your left breast."
Posted by: LK | Nov 19, 2008 7:24:32 AM
what a great story, thankyou kendra..
Posted by: marlene | Nov 19, 2008 2:16:49 PM
After the untimely death of my husband and a very traumatic following year, I had a breakdown. I just slept and cried for three days continuously. Lying on a bed in ER, the crying continued and I felt numb and unresponsive. The doctor examining me placed both my hands on my stomach and held them in his. Suddenly I could feel energy coming back into me and my crying slowly turned into intermittent sobbing. He then started to lightly brush my hair back from my face and I felt very comforted and ceased crying altogether. I even laughed. The relief was great. After a sleep I felt restored. Touch is powerful.
Posted by: ML | Nov 19, 2008 5:40:01 PM
Me again! When my husband was first diagnosed with cancer, his doctor held both my hand and his as he talked about treatment. It was a deeply reassuring and comforting gesture.
Posted by: ML | Nov 19, 2008 5:45:14 PM
i personally fascinate about the power of touch. I love your thought, and please continue with it.
Posted by: chloe | Nov 19, 2008 5:55:58 PM
"My" patient died this morning. She remained in the room for a little while, and I wasn't sure if the other patient in the room was aware of what had happened. Back and forth I went, the student forever running around on the spot. I eventually walked up to her. And we cried. And touched.
I promised her that I would call my mum today.
Posted by: Jay | Nov 19, 2008 8:25:42 PM
thanks indeed for putting a smile on your patients face. thats what we are trained to do not cause pain. i am certain you find a hand to hold when the need arises.
Posted by: obadas | Nov 20, 2008 1:25:12 AM
Beautiful... That human touch is part of the old art of medicine and healing. I totally agree that our very energy can help the patient in some way, at least psychologically. We shouldn't forget that we are scientists AND artists.
Posted by: Felipe Gorena | Nov 20, 2008 3:22:59 PM
Spot on. LOve is always the answer.
Posted by: Kia | Nov 20, 2008 10:32:15 PM
Yes, I totally agree with what you said. Human touch is really a powerful thing. Holding someone's hand can somehow ease the pain. It's like telling the person that someone is there for him/her no matter they're going through.
Posted by: Mari | Nov 20, 2008 10:47:16 PM
i was touched by you...and i hope that you may continue touching other peoples lives...im a nurse and being a nurse i was happy knowing that there are doctors like you who provide warmth and care for the patients...God bless you and keep up the good work!!!
Posted by: katherine may | Nov 21, 2008 5:52:21 AM
Bravo for your thoughtful action..
Thats it(signe de recognition),communicating care to the patient not only as a patient but as human being needing all the basic needs of life(most importantly affection)in either small or large sense.
Posted by: eric | Nov 21, 2008 2:54:34 PM
Posted by: louvelle | Nov 21, 2008 8:19:43 PM
Thank you .
It works. The Touch...
Your story washed off my 'blue' , it's frustrating sometimes when i have to face the terminally ill patients, feel myself helpless when i cant take away their pain.
thank you , again.
Posted by: deniz | Nov 24, 2008 3:12:13 AM
ML What a fabulous, wonderful ER doctor, you were very blessed. i am so happy someone like him came into your life at the very right moment. Where, oh where, are these physicans...???
Posted by: tfb | Nov 24, 2008 10:33:32 AM
ML you were truly blessed to have an ER doctor that took the time to just be with you in such a low point of your life. It is true that human touch makes such a difference in a patients experience - whether it be a touch on the shoulder, arm or the holding of a hand. I work in a hospital in two capicities - placement in the radiological prodecures department and as a waitress in the coffee shop and I use human touch to comfort all the patients and family that I come in contact with.
I can see Jon's concern regarding awkwardness/sexual overtones - but obviously the patient does not feel comfortable with you in the first place if you cannot have a basic human connection with them. All the male doctors that work in the radiology department have this physical contact with both male/female patients before and after procedures and they have no problems/complaints made against them.
All the students/nurses/doctors that use the power of human compassion and simple touch in their everyday pratice will have more positive experiences and generally happier (or should i say more comforted) patients.
Posted by: Amy | Nov 24, 2008 7:48:32 PM
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