The Healing Touch and the Teacher
I remember it as if it were yesterday, the spacious auditorium in the then-new Boyd Orr building at the University of Glasgow. The oncologist, young to be the Chair of the department (but so wise), lectured to us about the importance of touch in patient-doctor communication. Not salacious touch of course, but touch for support, empathy, and reassurance. It may be holding a trembling hand, or a gentle squeeze to the elbow. It may be a hand laid on a shoulder. He talked about how physicians can be “touchers” or “non-touchers,” based on their personality. But all could be taught to be touchers.
The hands laid on the body have always been part of the physician’s actions. As students, we learned that it was essential to the physical examination; feeling the “thrill” of turbulent blood flow, palpating the thyroid for nodules, pressing on the abdomen to feel the guarding indicating peritonitis, and of course, the breast exam to detect masses.
In the era of extensive imaging, the physical exam may be in jeopardy. There can be too much reliance on a negative imaging test even when a physical finding is present. I have been a patient myself, of course, and I remember the feeling of betrayal as I sat there covered only in a gown as the doctor left the room having failed to perform a physical examination. It had been forgotten. I had undressed for my yearly “physical” only to have a discussion of my lab results. Touch in patient communication is more just than the exam however. It is part of the whole interaction.
The oncologist was Professor Kenneth C. Calman, who was also the honorary president for my graduating year, 1981. He went on to become the Dean of Postgraduate Medicine at Glasgow University, Chief Medical Officer for Scotland, Chief Medical Officer for Her Majesty’s Government, Vice-Chancellor of the University of Durham, Chairman of the Calman Commission and Chancellor of the University of Glasgow. He was knighted in 1996.
2011 marked the 30th anniversary of the Alpha ’81 club. Professor Sir Kenneth attended and I had the chance to tell him what a profound effect his “touch” lecture had on me all those years before. I put his words into practice every day in the office and operating room. I am so grateful for his teaching and the chance to thank him personally.
The other day, when I was in the recovery room talking with a patient post-op about her negative axillary nodes, I squeezed her toes as I said goodbye. Touch is part of what keeps us together as humans. It binds us.
Tags: communication, Glasgow University, Kenneth Calman, patient-doctor communication, physical examination., Professor Sir Kenneth Calman, touch, University of Durham, University of Glasgow