How Touching Saves Lives

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When I was a fourth-year medical student, I once did a month-long rotation in the ER. One night a woman came in who we decided needed some lab work. When I let her know we needed to draw her blood, she began to tremble visibly. “I’m scared of needles,” she whispered to me.

She squeezed her eyes shut as the phlebotomist set up next to her gurney to draw her blood. “It’ll be over before you know it,” I tried to encourage her. She didn’t even acknowledge I’d spoken.

The phlebotomist glanced at me once, concerned probably more that the patient was going to jump or prove to be a hard stick, and then said to her, “You’re going to feel a little poke.”

The patient tensed, tears appearing at the corners of her closed eyes. Not knowing what else to do, I reached out and took her hand, feeling awkward and foolish as I did it. She clamped down on my fingers so hard she actually hurt them until I shifted my grip to better allow for the force of her squeezing. When the needle went in, she clenched my hand even harder. I felt strangely and warmly connected to her, urgently wishing the phlebotomist would finish as quickly as possible.

When it was over, the patient continued to lie there with her eyes shut, my hand still in hers. I watched as she forced her breathing to slow and then opened her eyes. She dabbed at her tears with her free hand and then looked directly at me. “Thank you,” she said in a relieved voice. Then she gave my hand a final squeeze—this one mercifully gentle—and let me go.  My hand started throbbing a little, but I hardly noticed.

WHAT TO SAY WHEN WE DON’T KNOW WHAT TO SAY

Most of us have had a friend or a loved one tell us something that happened to him or her that was so awful we didn’t know how to respond. Perhaps we heard about a new diagnosis of cancer. Or about a spouse asking for a divorce. Or about the death of a mother or a father. Or a child. When we hear some stories, we recoil at the immensity of the storyteller’s suffering, often finding ourselves grasping at platitudes that feel entirely inadequate.

But people who feel as if they’re drowning in pain as the result of a devastating trauma tend not to want to hear platitudes and almost never want to be convinced things aren’t as bad as they seem, even when they’re not. Words of comfort, even if spoken awkwardly, are usually appreciated when the intent to comfort is genuine and sometimes help immensely. Sharing a story of something similar that happened to us, showing someone we understand their pain in a way others can’t who haven’t experienced what they’re experiencing, is often remarkably soothing as well. But when someone feels utterly defeated or terrified by their circumstances, few things, in my experience, equal the power of the simple act of touching to provide comfort.

THE POWER OF PHYSICAL CONTACT

Perhaps because we must all face the trials life has in store for us by ourselves—experience pain, fear, doubt, and loss in the confines of our own minds and bodies (that is, no one can do our suffering for us)—when obstacles appear we long for evidence that we’re not alone, that others care about how we feel and what happens to us. There just seems to be something inherently comforting about the physical presence of others when we’re in pain or afraid. And nothing starts that comfort flowing like a touch. Words may come out wrong or ring hollow on someone’s ears, but a touch intended to comfort (on a hand, or a shoulder, or with an embrace) almost never fails to make them feel better. It requires just a little bit of courage on the part of the one who touches—courage to invade another person’s personal space, to risk the scorn of the one being touched, and to volunteer one’s presence and one’s willingness to stand by another person in their moment of need. But I consider us lucky that we all seem to be built in such a way that something as simple and easy to provide as a kind and loving touch can bolster our spirits so much.

I try to remember the lesson that ER patient taught me as often as I can, especially now in my direct primary care practice that I have the time to spend with people in emotional distress. It helps me not to feel inadequate when I’m unable to find words of comfort in the face of someone else’s pain, and reminds me that what words of comfort I can find aren’t nearly as important as the message my attempts at making them communicates: I care. When I—as someone who prides himself on always being able to find not just the right words but magic words, words that illuminate, enlighten, and relieve—can find nothing appropriate to say, I remind myself that true brilliance comes from the willingness to share the burdens of others as my own, and that the simple act of touching is one of the easiest yet most powerful ways to do it.

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  • I recently shattered my wrist during a move to a new town. I was in shock and pain and had a hard time controlling my emotions in the ER. And then, when the cast was taken off four weeks later, I cried because I was so scared and still in quite a bit of pain. The orthopedic surgeon was so nice in both visits. He handed me a tissue and placed his hand on my shoulder. I was so comforted by this small act of concern. I appreciated the time he took to actually see me as a person needing some reassurance instead of just another patient in his rush to get to the next one.

    Thanks for the post. It’s an important point to remember in our quest to be kinder to one another.

  • When my nephew died of SIDS eighteen years ago, I couldn’t figure out why I didn’t feel worse when I returned home from the funeral. Then I realized we’d spent almost an entire week doing nothing but crying—and hugging.

    And did you know there are people called volunteer cuddlers? Who, with permission from the parents of course, hug premature babies into health?

    Maureen: I did know about volunteer cuddlers in the neonatal intensive care units. What a wonderful thing they are.

    Alex

  • I like this post a lot. In my career as a psychiatrist, touching was always a no-no, a boundary violation, medically unethical. I found it so ridiculous. I worked with teenagers who were in such pain, suffering from first episodes of psychosis or mania, often needing significant comforting.

    I don’t mind saying that whenever the treatment had finished I never refused a hug from a child or a parent. Although I’m not sure who it helped more, me or them…

    Thank you for this lovely post…

    Bobbi

  • Thank you, Alex.

  • There is touching. And there is that faux-hug where chests almost touch, butts extend in opposite directions, cheeks glance, and some mutual back patting goes on. Satisfying, but only like tepid weak tea. And THEN there is the hug, the most rewarding and intimate of touches possible. Where the release of both emotional and physical constraints allows sharing of compassion and space and loving-kindness and tears and the silence of breathing unto each other and into ourselves. The hug of loving family, loving friends, and bravely loving souls. Invariably contextual and incredibly comforting. Yay.

  • I’m so glad that you wrote about this, Alex. It seems as if everyone is afraid to touch these days because it could be considered inappropriate. Many years ago, when I started a six year tenure as a dean of students, I would see students who were suffering terribly. At first, I would talk to them but never reach out to touch, having been told that this was risky because it could be reported as inappropriate touching. But after six months or so, I “threw caution to the wind,” and when someone was in physical or mental pain (it was usually to latter) and it seemed like the best way to help, I’d reach across the desk and put my hand over theirs. It never failed to amaze me how much it helped. It was so much more effective than all the platitudes I could offer.

    Years later, due to chronic illness, I’ve found myself in need of comfort several times in doctors’ offices. But I can’t remember a single instance where a doctor has put a hand on my shoulder or made any kind of physical contact, even though I know it would have helped me. I can’t help but wonder if they’ve been instructed not to touch patients for any purposes other than as part of a physical examination. If so, it’s a sad commentary on our culture.

    Toni: I completely agree. It’s easy to argue there are inappropriate ways for doctors to touch patients (perhaps even touching a knee is less appropriate than a hand or a shoulder) but in our highly litigious society professionals have become overly”touch shy.” It’s also, I think, far more intimate to touch someone, even on the shoulder, for example, than to say how sorry you feel for them—and intimacy is difficult for many professionals. And people.

    Alex

  • While I totally agree with what you have written, I am not sure all people feel that way. I have a very strong sense of personal space and I do not like to be touched or hugged by anyone. I definitely enjoy being with people and consider myself social, I just prefer not to be touched.

  • It’s a tricky topic.

    When I want to be touched, I REALLY want it. But when I don’t want to be touched, I REALLY hate it.

    Emily: You raise an important point. A comforting touch may not always be welcomed. It’s a tricky business knowing when it’s okay. You always have to read others as carefully as you can.

    Alex

  • I am involved in teaching medical students. We talk about doctors touching patients and it is a very interesting seminar for me and for them—leaving always lots of questions. There is a big question for me why the doctors are not willing to touch patients in moments that the touch could resolve the pain? Is it really our society—or is it the doctors being afraid to get close in relations with patients? Is society and law just an excuse to get further away from closeness with other person? Do you talk with your students about role of touch for doctor patient relationship? (This is open question to those that come here and are involved in med school teaching).

    I do touch my patients when I do feel it is appropriate to do. There are people with whom I will touch giving them support and there are those that posses strong borders that I will not cross.

    But standing in front a patient I do remember that being a doctor I am still just a person. I am not different from my patients and as they I will come to the points in life when I might need touch more then words to express compassion and empathy.

    And I do believe that touch saves lives, not only of our patients, but also ours, allowing us to fully express our compassion.

    Great post, Alex.

    Emilian: Thanks.

    Alex

  • As a physical therapist, touch is a big part of my tool box. In fact, I “look” with my hands more than with my eyes when I evaluate a patient. I have had patients who crave human touch and patients who recoil. To give the patient control and establish trust, I always ask first if I may touch them. I ask casually, but respectfully and always say where and why I want to touch them. People who have been abused or have other issues that make them touch averse require extra time and more peripheral touch at the start. I may even ask them to touch me first as in “push your palm against my hand.” Usually I find that there is an emotional shift when I am able to use manual techniques. It’s surprising how many people have cried at feeling a caring touch.I agree that the power of touch should never be underestimated.

  • Compassionate touch is a most human act.

    Children are unafraid to take what they need (a hug). I recently had the experience of making eye contact with a 3-yr-old boy who was being a bit fidgety. He responded to my smile by running over for a hug. He was calmed by the “new situation” and returned to his grandmother, but I was surprised by the next request: A man dining with his wife and family who asked if HE might not have a hug! I said “of course,” and we all went back to our previous involvements.

    Touch is so reassuring, it says, “You’re o.k.,” and we’re all in this together. Beyond the symbolic meaning, it just feels good.

    Yet, I have hugged people uncomfortable with it from whom you leave feeling cold. I feel sad for those people.

  • I agree with everything you’ve said but I wanted to add one thing. You focus on the power of touch when people are in pain, but for many touch is extremely important even when one is not in crisis. I myself have next to no personal space and generally find that the only people I can remain close to (as friends or anything else) are those who either welcome or at least do not mind casual touch.

  • This was another terrific article, Dr. L. When I train teens to be Eucharistic Ministers in the Catholic Church I really emphasize that brief moment of touch—and I now have some new info (your article) that I can share with them. On the flip side, being the recipient of touch while a frightened patient is an extraordinary comfort—one that at times cannot be described. So much better than words when one is frightened, sad, in despair etc—you are so right on—again. Wish you could elaborate on this one—touch is so very important, and like sleep, so underrated.

    Colette

  • Great post as usual. As others have pointed out, it’s a “touch-y” subject which can go both ways in our rather touchless society. But when done right, when you follow your instinct to touch as you did here, you can really tap into something primal and comforting.

    Beno: Thanks.

    Alex

  • Excellent and profound insights, Alex. I wish you were my doctor.

    I am a recent graduate of an excellent college of massage therapy. Our 1000-hour certification program included several hundred hours exploring the ethics of touch, personal boundaries, and developing our sensitivity to the complexity of the person with which we are present. Oh, that more doctors would connect with their patients in this way. As massage therapists, we are often the only conduit providing the most basic of human needs, touch, especially with elderly populations who are often not only mentally but physically lonely. As mammals, we are pre-wired to receive touch. Babies who don’t receive human touch can wither and die. My personal epiphany, the calling that changed my profession and brought me from the world of administration to ministration, occurred when my beloved uncle was in the final stages of Alzheimer’s. He was submerged in his own world, with no sign of recognition in his once bright eyes. He stared at the ceiling and repeatedly wrung his hands, head lolling back and forth. I sat down on the bed next to him and asked him (always ask!) if I might hold his hand. Of course he could not answer me, but I gently took his hand in mine. His head turned and then his eyes met mine. At that moment of contact I could feel, I knew, that Nevin was still in there somewhere. It was a simple, human touch that brought him back to me for a few moments. Never forget that touch is the first thing we learn as infants, and I believe it is the last thing to leave us in our dying. I have found the best career, providing comforting touch and healing touch, and will be forever grateful to my uncle for showing me the way.

    Julie: What a story. Brief but so moving. Thank you for sharing it.

    Alex

  • Thank you, Alex, and thank you, Julie. I am also a massage therapist. Yes, I address the aches and pains, but it is the safe compassion of touch, to be tended to and cared for—and indeed, the pleasure of touch as well—that brings the glow of peace to clients, and with it, healing. A massage license is a license to touch—I am honored and feel blessed to have that responsibility that others trust me with.

  • Thank you, Alex. I volunteer when I can with children and one of my favorite moments was helping coach T-ball. We had this little guy that I got a real hug (and smile!) from after a difficult situation. It completely changed my attitude towards him and I relaxed, he relaxed, we had more fun and I got a bigger picture instead of the limited I’m-annoyed-with-your-troublesome-behavior.

    Elizabeth: That’s a great story.

    Alex

  • Very interesting to read how a simple touch can overtake any amount of spoken words. There is no doubt that touch has a magic in it. Touch invariably connects two souls and pass energy between two individuals. There is no better way than touching someone to assure them that we are beside them in the hour of their need. Thought provoking article, indeed.

  • Thanks for a great article; it brought back one of my favorite memories of touch. Fourteen years ago my marriage was in the process of unraveling and I went into a church just to sit and meditate. I found a seat near the back and as the service started I found myself crying silently. I was sitting alone, and didn’t know anyone there, so I just let the tears roll down. After awhile it was time for people to walk to the front for communion, and as they passed by me someone reached out a hand and laid it briefly on my shoulder. I never even saw their face, but to this day that simple, silent touch is still one of the most beautiful, loving and comforting experiences of my life.

    Tina: That is a cool story. Thank you for sharing it.

    Alex

  • “But people who feel as if they’re drowning in pain as the result of a devastating trauma tend not to want to hear platitudes and almost never want to be convinced things aren’t as bad as they seem,”

    This sentence is the key. Forget the platitudes, including the spiritual platitudes. Acknowledge the pain the other person is feeling. And yes, touch them.

    Almost no one in this culture has been held or touched enough.

  • So much in here—

    Miriam’s comment: Almost no one in this culture has been held or touched enough. So true! Massage therapists here point out one acceptable and powerful way in which touch is permitted and enabled. Even a touch on the shoulder (as one commenter relates) can become holding. Sometimes silence can do it, but a particular kind of silence. When I was doing counseling, my besetting problem was talking too much. When someone was moved, even to tears, but the situation was not (in my judgment) suitable for holding, if I could just sit still in respectful presence and attention, not turning away—it would amount to holding. (For myself as client in therapy, this is true as well.) But when actual touch is possible, there’s nothing quite so efficacious. There’s a kind of “movement” called Free Hugs, and I posted a YouTube video of it, Free Hugs in Sondrio, Italy, https://touch2touch.wordpress.com/2010/08/30/free-hugs/ on my blog. I don’t know how it affects visitors who watch it, but I haven’t been able to watch it even once (and this is after many times) without being reduced to tears. But they are healing tears.