Touch

We were out this weekend to listen to live music (the best way to spend the weekend in my opinion). I felt somewhat uncomfortable because so many of my partner's friends, and mine, were very touchy. Rubbing my back, my arms, holding my hand while they spoke to me. Even hugging these folks I hadn't seen in months felt strange.

Growing up, my family was not terribly affectionate. It was something I'm proud of cultivating with my younger siblings. We hugged, kissed and snuggled. Now when they talk to me on the phone they say they love me, we hug every time we see each other.

But I'm not that way with other people. My very good friend in the class mentioned that we don't hug because "I didn't think you were a hugger" - however when I recently met her mother, it was the first thing we did after saying hello.

My idea of touch has changed dramatically since entering medical school. There are several kinds of touch as I see it.
1. The "hand shake". Typically done at the beginning of a new experience with a patient.
2. The "my hand is on your shoulder now because I'm using my stethoscope" touch. It's mildly familiar, helps me know when the patient is breathing if there is too much consolidation to hear well and gently reminds the patient to hold still/not speak.
3. The "this is something I have to do clinically touch". Reserved for DREs, breast exams, pelvic exams, genital examinations. It's all business, get in, get out.
4. The "you're having a really bad day" touch. I'm comfortable with this one even though it's bordering on quite familiar. When I am chatting with a patient with some sort of terminal illness or who has been in hospital for a long time, or with whom I am sharing bad news, I automatically rest my hand on their leg or hold their hand. I worry sometimes that this is more paternalistic than it should be. It's not intended to be, it's how I deal with people having a bad day.
5. The "tickle fit". Strictly reserved for kiddos under the age of 3 who are mostly feeling well. I call it developmental observation.

It seems like my comfort level with touch is divided into two categories - family and non-family. Time to split the second group into friends and patients.