The Power of Touch
"Jim" is a 66-year-old male with
traumatic brain injury (TBI) with personality, cognitive, and behavioral
deficits secondary to this injury. He had become a familiar face at our
psychiatric unit because of his numerous previous admissions for the inability
to take care of himself. He was found covered in his own waste in an apartment
with no food and numerous empty vodka bottles. He was evicted from his
apartment shortly afterwards and was homeless. Thus, he remained in our hospital
for several weeks until appropriate housing was found for him.
While in the hospital, he refused to
participate in groups because he did not want to "listen to other people's
used the "f" word or any other assortment of swear words a bit too frequently.
Showering was not his thing, so he cleaned up only once during his prolonged stay and
became quite agitated if he was bothered with this. He disliked people who were
black or had accents, refusing to work with them. Unfortunately, this meant
that most of our nursing staff was excluded from working with him, so soon he
had run out of nurses that were "allowed" to care for him. He looked rough,
mean, and intimidating.
One day, secondary to his poor
hygiene, he had developed a severe back abscess that required I&D and daily
wound packing. Needless to say, it had become a daily battle to convince him to
cooperate with the wound care. One day, while packing his wound, a PA did
something that took "Jim" by surprise-in an effort to comfort him, she had
touched his hand. "Nobody has touched me in more than 30 years," he confessed.
She had shared this with the rest of the team during our meeting the next
morning. "Jim" cooperated with all of his wound care afterward and allowed a
doctor with an accent to do his wound debridement under local anesthesia.
I learned to never underestimate the
power of touch. Now, I start most of my physical exams by first examining patients'
hands (radial pulses, strength, sensation, or hydration status; there is plenty
one can do). Somehow, it puts patients at ease.