Tuesday 13 May 2008

Touch

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.

7 comments:

Jellyhead said...

How lovely that you shared a sweet moment with a ninety-something lady! She must have thought you were a darling.

I find the touch issue is a tricky one. I use touch fairly sparingly - mostly if someone is crying, or I suppose I do often touch the shoulder of an 'oldie' as they walk out. I'm aware that as partners and friends pass away, and the younger generations rush around in a mad rat-race, some of these lovely older generations get very little touch at all in their lives. Of course, it's easier for me, being female - no accusations of sexual harrassment are on the cards!

However, on the issue of patients touching ME - I have a delightful patient in his 90's who kisses me on the cheek every time he leaves me. It embarrassed me at first, but now I just grin and hope that it makes his day brighter!

Anonymous said...

'Touch' is a fascinating subject. I think we rely heavily on instinct to know when a gesture of touch is appropriate, and when it's not. I agree, it can be difficult to interpret when in a professional setting but sometimes, no words can be found to replace the effect of a gentle touch.

I admire your stance on giving women the support needed to make the right decision (for them) re termination of pregnancy. Surely it's more important that women today can feel safe in seeking qualified advice rather than 'going it' alone without any opportunity to consider the options.

Sadly in Ireland, religion dictates that women often resort to the wrong measures through lack of support and advice.

I agree with that little old lady, you are good!

Anonymous said...

Touch is an extremely sensitive topic. Please excuse the horrible pun. Particularly amongst religious individuals. One has to be so careful not to offend or to give the wrong impression.

Anonymous said...

I wasn't quite sure how to take it when my GP squeezed me gently on both elbows as I left his consulting room recently and told me to take care. I'm not THAT old (but about ten years older than he is). He, like you, isn't normally a touchy-feely sort of person so it sort of took me by surprise. I've always found him quite attractive so I possibly read a little too much into it. But it was nice and I have no intention of complaining!! (I have chosen to use an anonymous tag today just in case it gets back.)

Anonymous said...

I kind of wish I hadn't left that comment now, but your site doesn't seem to support removal by the authors. Was I being overly sensitive about a moment's kindness? I hasten to add that there has NEVER been any suggestion of improper behaviour on either side and I wouldn't dream of telling him I like him as it would probably embarrass both of us.

Anonymous said...

You lucky sod. I've used "can you hear me, mother?" in my non-medical world a fair few times without ever scoring a hit.

Dr Andrew Brown said...

Thanks everyone for the comments.

Jellyhead: Glad to hear things are much the same Down Under.

Steph: Thanks. I'm good on good days. :-)

Itamar: I'm not sure whether religious people are more sensitive, but you certainly have to be careful.

Anonymous: The blog does allow you to delete messages, but not if you post them anonymously because it has no way of identifying you when you return. Don't worry about your GP, he won't recognise you from the post. And I suspect he is quite fond of you, in a perfectly proper way.

Dearieme: Keep trying - perhaps with older people. :-)