The disappearance of sympathetically affects medicine

Being a doctor, I was taught to appreciate the importance of touching people in a way that affects our physical and mental health. As a person, I worry about its loss. And as a dermatologist, I know what that loss can mean to the loneliest and most vulnerable among us.

Scientific studies prove that human touch – whether it’s a quick hug, holding a baby, or a professional massage – is important for mental and physical health. Untouched babies can die, and even as adults, touch causes our brains to release oxytocin, dopamine and serotonin while reducing stress hormones such as cortisol and norepinephrine. . Touch builds our immune system, helps our body fight infection, and can help regulate digestion and sleep. Even petting a dog or cat can slow heart rate and lower blood pressure.

For my psoriasis patients, touching up during medical exams serves all these purposes and more. Psoriasis is a chronic skin condition that causes raised red patches on the skin. Although it is not contagious, its appearance has long been misunderstood, causing stigma and fear. Although the public will understand psoriasis better in 2024, for centuries, people with psoriasis (between 2-3% of the population) were misunderstood and discriminated against. For patients with this condition, touch can be an affirmation of their personality.

Before this epidemic, healing touch was a natural part of my patient interactions. However, Covid-19 has brought about a big change. With social distancing, protective equipment, and the growing fear of infection, physical contact has unfortunately become a rare occurrence in the examination room. Now that the crisis has been reduced, the challenge is how to balance safety with the need to return healing to care. Recent changes – both good and bad – have eroded the stereotypes I took for granted. Technology allows millions of us to work from home, often alone. The Covid pandemic has in some cases eliminated the practice of handshakes, hugs, and other forms of greeting, especially for those of us in the medical field.

The increasing prevalence of unwanted touching has been an important step in protecting personal boundaries. However, it has also created new problems, especially for doctors. Many doctors who once used touch – with permission – to connect with their patients now avoid touch whenever possible for fear of being misinterpreted.

Additionally, the rise of technology in medicine, while beneficial in many ways, has further reduced the use of empathy in patient care. A physical visit (which has brought health care to millions of people who could do without it completely) does not have the personal connection that a physical examination provides.

How can doctors return to a level of comfort with physical touch now that it has been reduced, while testing which patients are comfortable with it? We need to make sure we ask for consent, respect each patient’s boundaries and what they need for healing and connection.

When I see my dermatology patients, I realize that, because of their skin conditions, many of them have different experiences and feelings about touch – and the lack of it. I want to show them that their skin disease is not contagious and nothing to be afraid of. I might hold their hand, lift their hand, or help them turn their body.

“I’m not afraid of you. Your skin is not afraid. I care about you.”

All this is said without words.

Of course, there are some people who don’t like to be touched – who aren’t “hugs.” But for many of us, it is a comfort and connection that is as important to our lives as seeing our doctor. Patients and doctors alike have told me that they miss the presence of healing touch in their interactions. One patient said that her primary doctor did not touch her at all during her visit, which made her feel like she had not been “seen” – that the diagnosis was it was not perfect. He told me: “I felt like I was being manipulated,” instead of being healed.

Perhaps this is the crux of the matter: As doctors, we do more than treat patients. As President of the Internist and Massachusetts Medical Society Dr. Barbara S. Spivak explained, “In order to help them heal, we need to understand who they are, what is important to them, and what affects their lives in life.” see.”

We are called caregivers for a reason, and one of the most important ways people show they care is through a healing touch: “Whether it’s checking on them, or holding their knees or shoulders they see that expressing pain—emotional or physical—helps transfer. that feeling of being accepted, understood and cared for is very important,” said Spivak.

So, as doctors, we must not forget the importance of touch to heal. Seeing a patient doesn’t just mean making eye contact. For many, it also means reaching out.

Alexa B. Kimball, MD, MPH, is CEO of Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Center in Boston.