One of the first things we did in my clinic rooms when the COVID-19 pandemic hit was to put a large piece of black tape on the floor of our exam rooms and place the patient chairs behind it. This was at least six feet from the rolling chair where the clinician would sit at the computer to document the visit. Social distancing was in effect and therefore, there was no way to hold a hand while sharing results with a patient, no way to make close and meaningful eye contact that conveyed your empathy, and certainly no way to put your arms around a patient or family member who was grief stricken.
Not only did the black tape on the floor designate this human gap, but also a generally unspoken fear amongst us all, early on in the pandemic, that a deadly virus could be passed on at any time, so you are better to stay away from people. Now that vaccines are in place, deaths have significantly declined, and the world starts to open more, where has that left us as clinicians who care about our patients with cancer? The virus is still flourishing, though less deadly and more treatable. But should we get back to closer contact with our patients?
I have always been a “hugger”. There are verbal and non-verbal cues as to when a patient or family member may want a hug or when that person is giving the signals of “don’t ever think of touching me lady”. I don’t hug everyone, only those who consent to wanting a hug or offer or request for a hug. This came into clear view with a patient of mine a few weeks ago.
Mrs. R is a 50-year-old woman who lives alone and has really no family or friend support. She is indigent and lives on a very low fixed income. Her personality is usually agitated, mistrusting, and withdrawn. She has head and neck cancer and a tracheostomy that is capped, but causes her to cough at times and have mucus. She is on chemotherapy and radiation, and is very frail, only weighs about 90 pounds, and cannot swallow much at all due to the burning of her mouth. She sits in my office, in front of me, with a low blood pressure, weak, dehydrated, and in pain.
We discuss that she will be admitted to the hospital to help her finish radiation treatments and she agrees that this is necessary. Instead of becoming angry, which I was prepared for, she coughed up mucus from her disfigured and raw mouth and began to have tears well up in her eyes. We looked at each other, I asked her if she wanted a hug, and she shook her head yes. I buttoned up my lab coat, made sure my hair was pulled back tightly, adjusted my eye protection, made sure my mask was tight on the nose bridge, and I went in and held Mrs. R in my arms. She wept and shook in my arms. It felt like she had not been hugged in years. When we separated, I could tell by her eyes that she was smiling weakly and we bonded in that moment. After she left the room, I sanitized my hands and changed my coat and mask. While this terrible pandemic has caused so much loss and made us afraid of each other, remember the human touch is something that can have so much power and can be done safely.