My Night on Call…The Human Touch

During my surgical training, I visited the UK, and was on call as a Senior House Officer. Having trained in Italy (and in the south), I used to create a connection with patients, which included some sort of physical contact, e.g., offering handshaking or placing a hand on the shoulder.

During one of my first outpatient clinics in UK, I introduced myself to a new patient, and invited them to sit while conducting the interview and I put my hand on their shoulder. The consultation went on without any issues (that was my feeling); however, at the end of the clinic, my responsible consultant asked me to have a quick chat. We had a coffee together, and I was told that the patient reported that my unnecessary touching had been an unpleasant experience which made them feel uncomfortable. I felt bad; the consultant smiled and reassured me that it was not a big deal, but I only had to learn to adapt to different ways of working and get used to different cultures.

Some weeks later, I was on a night shift covering surgical wards. During a ward-round in the evening, I saw an elderly gentleman. who had had one of his legs amputated. During the consultation, I felt he was feeling uncomfortable with a strange doctor not from his surgical team assessing him. I had a brief chat with him and afterwards offered my hand. After some hesitation, he shook my hand. The following night, I visited him again, he seemed more relaxed and we had another brief but pleasant conversation; this also happened on the following two nights.

The weekend passed, and I was on a ward round with the colorectal team when we  visited the same ward as the gentleman with the amputation. I saw him staring at me and I nodded my head to greet him. He smiled and made a gesture to come closer. I did, and he offered me his hand. I explained I was not visiting him that morning, as I was no longer on call anymore. He said, “I like the way you touch people.”

I reflected on that. Touching people who need medical or surgical care can help to establish a connection, making some of them feel more comfortable, whereas for others it can be seen as an unnecessary violation of privacy, especially if they have seen many other colleagues. Since then, I have tried to work out a way to approach each individual patient. This is not taught with formal training, but it is an important non-surgical skill that all surgeons should develop.

The name of our profession has its roots in the word “hands”. Surgery comes from the Latin word chirurgia and Greek  derived from χειρουργία [kheirourgía], from χείρ [kheír, hand] and ἔργον [érgon, work]. Touching, not intended as a paternalistic motion (which could establish an unbalanced relationship), is a powerful way of relating to our patients. It should be offered with appropriate timing and manner, after making sure that our patient is comfortable and agreeable.