I'm not a touchy-feely doctor. During the physical examination contact can hardly be avoided, but I don't constantly grab patients' hands, pat them on the back or clasp them to my bosom. Partly because of my reserved English nature, and partly because I don't want to give the wrong impression. Having said that, if elderly ladies become distressed I may lay my hand on theirs. And, as mentioned before, I love cuddling babies.
But patients do occasionally touch me, which I don't mind as long as I know what the gesture means. The French statesman and diplomat Talleyrand is said to have remarked “I wonder what he meant by that” when he learned of the death of a Turkish ambassador. I don't obsessively seek for the meaning of everything my patients do, but touching the doctor is an unusual event which demands explanation, and it has happened to me twice recently.
Yesterday a young woman made a light-hearted remark about her fertility and rubbed my shoulder as she left the consulting room. This was, I think, an expression of relief. She had come to ask for a termination of pregnancy, and as she had not met me before she hadn't known what to expect. I don't subject anyone to the moral third degree about this, or anything else for that matter. I say that of course I will refer her if she wishes, but I also say that it is a difficult thing to go through and women often feel upset about it afterwards. We talk a little around these issues and I then make the referral, depending on how the discussion has gone. In the past some of my partners have expressed their sorrow that I do not take a stricter moral line, but I prefer to discuss matters of morality alongside the patient rather than opposite them. I suppose her relief was justified, as she might have ended up seeing one of my stricter partners.
Then today a woman in her nineties came to see me, accompanied by her daughter. She wears a hearing aid in both ears, and asked me to check for wax. I duly inspected her ear canals and waited for her to replace the aids. Then I said “can you hear me, mother?” She grinned, touched my hand, and said “he is good” to her daughter. I don't think the daughter picked up my reference to the late great Sandy Powell, and I was pleased that we had shared a little secret that had skipped a generation.