The congratulatory pat on the back from your soccer coach after you score a goal. The leap into a loved one’s arms after an awaited reunion. The shaking of a doctor’s hand after they tell you that they will be the one taking you into surgery.
Something that has garnered a lot of discussion is how will we view touch post-COVID19. Will we continue to, subconsciously or consciously, social distance?
Touch has been integral to the very essence of being human since the beginning of time. We cannot explain touch purely in terms of proprioceptors and dorsal root ganglia, it is about forming an interpersonal connection. Of Aristotles five senses (Sorabji, 1971), I believe it to be the most important in being a good doctor. Babies that are held and loved experience stronger health outcomes than those who are shown little affection. In obstetrics, kangaroo care (when a newborn is strapped to the chest of their mother or another human) is a proven method of delivering positive outcomes for foetal health (Jefferies, 2012). Pain stimulation studies have shown that when women were holding their partner’s hands, they experienced less pain than when they were by themselves (Crawford, 2018).
Touch has been proven to be the sensory stimulation necessary for developmental milestones (Ardiel and Rankin, 2010). Touch is able to reduce stress, lower blood pressure, heart rate and activate the parasympathetic nervous system. That sounds like the profile for a wonder drug as it has no side effects! Touch can save us from loneliness. Touch starvation, or a long period of time without touch, has been shown to have a corresponding relationship with rates of depression according to Beyond Blue. It reminds us that we are all made of the same substance, we share in the joys and pains of life together. Touch is able to send such a clear and heartfelt message. After the New Zealand tragedy, the iconic picture of Jacinda Arden embracing a griever spoke volumes. It was solidarity, grief and empowerment all in one action. When world leaders are shown giving awkward handshakes the media picks up on this because humanity views touch so highly, we observe it closely and appreciate when it is given in empathetic and nurturing ways. There are of course cultural and personal differences in how appropriate certain touching is. But that can be chalked up to the fact that everyone has different perspectives on life. Touching should never mean crossing boundaries; it is a dual experience and always requires confirmation if it is appropriate.
Touch is not solely limited to human contact, and when we are unable to receive it, we must look to other means of feeling in touch with the world around us. In the time of COVID19 there has been a surge in interest in becoming home gardening; nurseries are struggling to cope with quadrupling of demand as newbie gardeners attempt to create oases in their backyards (Ainge Roy and Gorman, 2020). There are many reasons for this; ample free time, and interest in trying something new, living confined to our homes and providing ourselves with fresh and nutritious food to enjoy. There is also the theory that we long to touch living things, to feel their vitality between our fingers. How satisfying is it to knead bread and then watch it rise, as though it is alive?
During our social isolation we have been substituting touch with videocalls, meme tagging, gifs and long texts to share our feelings. These are effective ways of communicating but we must recognise them for what they are – substitutes. Nothing can fully replace the value that is derived from connecting physically with each other. COVID19 has been a period where we test the extremes – what happens when we are dependent on technology for majority of our interactions with each other? I hope that this saturation will help us see how important it is to have a healthy relationship with technology and value it as a flavouring to life rather than the meal. There’s always too much of a good thing.
In the realm of medicine, touch in the time of COVID19 has become a prominent concern. Telehealth is not yet in focus as a mainstay of healthcare delivery, but with the growing demand for technologically dependent means of communication it may soon become a mainstay of doctor-patient communication (Martina et al., 2014). Telehealth removes one of the most critical aspects of being a good doctor – eliciting clinical signs through examination. With the touch of our fingers we are guided to the pathologies of diseases; the triad of jaundice, fever and right upper quadrant pain was a diagnostic criterion for cholecystitis long before the advent of CT (Harrisons, 2011). Many doctors have cited the significance of touch in a healthcare setting, both as a means of clarifying disease and of creating a bond of trust and openness between doctor and patient (Gunderman and Leland, 2016). I love how keen doctors are to bring us students to feel hypersplenism (with lovely patients being so patient!!), 5 of us elbow to elbow, appreciating what it feels like. Can you replicate that understanding?
There are endless reasons to admire the healing and transformative nature of touch; but what will our world look like when social distancing restrictions cease but a fear of transmitting infectious persists? Our society has transformed from one which prided itself on its large music concerts, with arm bumping wonderfulness, to one where sterility and ‘cleanliness’ can only be achieved by staying 1.5 metres from each other. Heartbreaking stories of families unable to visit their dying loved ones infected with COVID19 have ripped through the very fabric of our society. It is at these times when embraces have elevated value and heightened need. I have seen the fear in people’s eyes as they call me out for standing too close to them in the supermarket. I apologise, avert my eyes and move on, but it strikes something deep inside me – will we be afraid of the ‘other’ long after COVID19 has become a moment in our tumultuous history?
A world without touch would mean us losing one of the most beautiful parts of who we are. There is so much that we gain through being there for each other. Whatever happens, I know that we are a resilient species. I have faith that we won’t let the corrosive nature of fear eat into our connections with each other, we are stronger than that. We just must not forget the importance of touch and hopefully when we return to ‘normal’ we will value it even more.
Ardiel, E. L., & Rankin, C. H. (2010). The importance of touch in development. Paediatrics & child health, 15(3), 153–156. https://doi.org/10.1093/pch/15.3.153
Kelly, Martina MB BCh BAO, MA; Tink, Wendy MD, BSc, FCFP; Nixon, Lara MD, FCFP Keeping the Human Touch in Medical Practice, Academic Medicine: October 2014 – Volume 89 – Issue 10 – p 1314 doi: 10.1097/ACM.0000000000000454
Sorabji, R. (1971). Aristotle on Demarcating the Five Senses. The Philosophical Review, 80(1), 55-79. doi:10.2307/2184311
Jefferies, A. L., & Canadian Paediatric Society, Fetus and Newborn Committee (2012). Kangaroo care for the preterm infant and family. Paediatrics & child health, 17(3), 141–146. https://doi.org/10.1093/pch/17.3.141