Phil Hammond MD

It's easy for doctors to construct an argument to get them out of touching

Monday 20 May 1996 18:02 EDT
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I know a GP who kisses his patients. Not all of them, mind, just the ones with ovaries. We're not talking slobber on the knuckles or whiskers against the cheek: he hits them smack on the lips. Now when I did geriatrics, I was tempted into the odd peck (not just with spinsters with large estates and no surviving relatives) and I assumed my colleague was doing likewise, but no, he kisses women his own age. Once when they come in, twice when they go out. He tells me they'd be disappointed if he didn't. Lucky bastard.

There's nothing in my General Medical Council handbook of professional etiquette that says you can't kiss your patients on the lips, provided "it isn't perceived as sexual". Loosely translated, this means don't open your mouth and come up for air every 10 seconds. But perception is in the eye of the receiver, and many doctors have been hauled across the front page of the Sunday Mercury for far less than lip service. I once worked with a Dr Ron Horrocks, who was a compulsive hugger. He hugged everything with a pulse and plenty without, but concentrated his efforts on the elderly. His theory was that people living alone can go for weeks without human contact and he was doing them a huge favour. Certainly he was terrifically popular, so much so that one mature lady started putting it about the supermarket that "Dr Ron gives me cuddles". This reached the local press, which put a most uncharitable spin on it, and he was forced to move to Suffolk, which was a pity because he was very good with the difficult patients.

It's easy for doctors to construct an argument to get them out of touching. True, there are some psychiatrically ill or confused patients whom it may be unwise to touch and some rational patients who don't relish the arm-around comforts of a sweaty health professional, but most of us find asexual human contact comforting in times of adversity. Indeed, massage therapists would argue that adversity is too late to discover the joys of "unconditional stroking". We need itto be at one with our physical, emotional and spiritual selves.

How do I know all this? I've just had a Watsu - or water Shiatsu, if you prefer. I'm not normally the kind of guy to go in for this sort of thing, but this was for television and I desperately want to be a TV star. I'll do anything to claim my rightful place on the couch with Dr Hilary. Even if it means taking off my glasses, exposing my beer gut to the camera and being bent double and pummelled in a boiling swimming pool by a strange bearded Dutchman. Pim de Griff is one of just three Watsu practitioners in the country and he's the business. "Most men have forgotten what it's like to be cradled by another man," he whispered as he elevated the experience from physical to spiritual. The whiskers tickled a bit, but the overall effect was surprisingly invigorating. And not in the least bit sexual. Honest.

If complementary therapists can get away with close physical contact, why not doctors? There are plenty of patients I'd love to submerge in a hot tub; "It's all right, Mrs Smallbone. The intimacy of aquatic bodywork represents a new way of being. Don't forget to breathe now." Sadly, not many doctors are that broad-minded and many go to great lengths not to touch their patients at all, not even to shake hands. This seems a pity as the key to the continued success of many complementary therapies is human contact. If we want to keep up, doctors have to rediscover the healing power of touch. But first, we need to sort out people who want to be touched from those who don't.

This isn't always easy. If a man pitches up to Pim for a Watsu, he can be fairly sure he wants to be touched. But if the same man comes to me for a repeat of his gout medication, I'm not so sure. For legal reasons, I have to get informed consent first. So I say: "Would you like me to touch you?" or, to avoid confusion, "Would you like me to touch you in that special way that only a doctor can?" Those who consent get a questionnaire to fill out. "How satisfied were you with the way your doctor touched you today? Name three things you liked most. Name three suggested improvements." I've tried this approach in my surgery for the last fortnight, but it'll be a while before the results appear in the Lancet. Preliminary findings can be found in the Sunday Mercury.

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