"Beneath Bleeding Hands:" Theological Reflections on a Doctor's Touch
PJ Wojda, PhD, University of St. Thomas
In a recent TED-Talk, noted author and physician Abraham Verghese criticizes contemporary medicine for its increasing neglect of the traditional “one-on-one” physical examination of patients. He calls on medical professionals to recover—and thus rediscover—the power of touch in the diagnosis and care of the sick and dying. In language and imagery bordering on the religious, Verghese refers to the physical exam as a “ritual” with a power to “transform.” His claim is not simply that such “old-fashioned” contact with the patient’s body—e.g., percussion, auscultation—will lead to better clinical outcomes, for he describes in moving ways his examination, at their request, of dying patients, themselves fully aware of the “uselessness” of the exercise, at least as far as their healing is concerned.
Verghese’s observations go the heart of our current disquiet over and disatisfaction with the nature and practice of medicine. Just how essential to medicine is such elemental physical touch between physician and patient? In other words, is the “old fashioned” physical exam more than just “old fashioned,” and are calls to reclaim it such as Verghese’s more than just exercises in nostalgia? While Verghese opens these questions, he does not answer them. This paper attempts to make a stronger case for Verghese’s claims, i.e., for the essentially tactile character of medicine, by drawing on two resources: Edmund Pellegrino’s phenomenological account of medicine and recent theological reflection on the essentially “embodied,” i.e., tactile, character of Christian faith. The paper seeks to contribute to the developing dialogue between medicine and religion by showing both how a “tactile” faith can bring forward the importance of otherwise neglected elements of medical practice (such as the one-on-one physical exam), and how a “tactile medicine” of the sort commended by Verghese (given foundational support by Pellegrino) can illuminate the powerful and transformative practical implications of a “tactile faith.”
In a recent TED-Talk, noted author and physician Abraham Verghese criticizes contemporary medicine for its increasing neglect of the traditional “one-on-one” physical examination of patients. He calls on medical professionals to recover—and thus rediscover—the power of touch in the diagnosis and care of the sick and dying. In language and imagery bordering on the religious, Verghese refers to the physical exam as a “ritual” with a power to “transform.” His claim is not simply that such “old-fashioned” contact with the patient’s body—e.g., percussion, auscultation—will lead to better clinical outcomes, for he describes in moving ways his examination, at their request, of dying patients, themselves fully aware of the “uselessness” of the exercise, at least as far as their healing is concerned.
Verghese’s observations go the heart of our current disquiet over and disatisfaction with the nature and practice of medicine. Just how essential to medicine is such elemental physical touch between physician and patient? In other words, is the “old fashioned” physical exam more than just “old fashioned,” and are calls to reclaim it such as Verghese’s more than just exercises in nostalgia? While Verghese opens these questions, he does not answer them. This paper attempts to make a stronger case for Verghese’s claims, i.e., for the essentially tactile character of medicine, by drawing on two resources: Edmund Pellegrino’s phenomenological account of medicine and recent theological reflection on the essentially “embodied,” i.e., tactile, character of Christian faith. The paper seeks to contribute to the developing dialogue between medicine and religion by showing both how a “tactile” faith can bring forward the importance of otherwise neglected elements of medical practice (such as the one-on-one physical exam), and how a “tactile medicine” of the sort commended by Verghese (given foundational support by Pellegrino) can illuminate the powerful and transformative practical implications of a “tactile faith.”