In Praise of Gentleness

Susan Gubar opens her latest post on the NYTimes Living With Cancer blog with “I’ve been lucky that most of my care is delivered with tenderness.” The “most” signals she’s about to tell us about an episode that still haunts her. She then frames the upsetting vignette with her astonishment it was isolated, emphasizing how “lucky” she feels about the tenderness of her usual care.

I assume she’s referring to the clinical challenge of touching patients tenderly when proper technique for an optimal outcome is “brutal.” The exact same touch, if done with intent to harm and/or without patients’ consent, would qualify as aggravated battery and land the offender in jail.

Gubar’s piece nicely highlights the artistry required for such a touch, as well as the role patients play in enabling that touch.

The distressing episode occurred when Gubar was conscious, but drugged and incapable of speech. Maybe the OR nurse did the best job possible, and pain was unavoidable. I wonder if the nurse could have watched more closely for signs of distress, such as an increase in Gubar’s heartrate. Might a momentary distraction have kept the nurse from focusing on using the least pressure necessary to get the job done?

The takeaway is the importance of patients’ verbal feedback in facilitating a healing touch. Caregivers can’t feel what their patients feel. Reporting discomfort opens opportunities for caregivers to adjust, either with a change in technique or, if that might jeopardize the outcome, with words of comfort and support.    

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