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More Voices


Every month More Voices invites readers to contribute short nonfiction prose pieces of 40 to 400 words on a healthcare theme.

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When my internal medicine residents put on gloves to examine a patient's normal abdominal skin, I see red. Don't they know that the easiest way to make our patients feel dirty and repellent, leprous and untouchable, is to deny them the skin of our hands?
 
So I challenge, "Why do you do that?" and I get back a litany of nonsense.
 
"It's good for infection control," claims one house officer. To which I reply: "So is telemedicine."
 
International graduates often tell me they didn't wear gloves for normal exams in their home country, but, "I thought it's required in the U.S." That sounds like a good excuse, but it isn't, because it's not true.
 
Another common response: "What if there's an open sore?" I don't say it, but here's what I think: "Yes, and if this man had a cancerous ovary, he'd need surgery to remove his ovary, but he doesn't and he can't (because men don't have ovaries!) and why are we are crossing bridges over abysses that don't even exist?"
 
Of course if we touch a wound or the inside of the mouth or other orifice, we wear a glove. Or if there is a pathogen for which infection control demands gloves. Patients understand that that's a different situation.
 
But otherwise we're sending a message--a distancing, hurtful and bitter message--to a person who already feels vulnerable and diminished. Why not instead show acceptance of the earthy reality of our mortal patients, whom we consent to touch with our own human, non-robotic hands? Why not convey that we are not afraid of catching mortality or humanity from our patients. Isn't that why we shake hands, skin to skin? To set the tone?
 
There is no evidence base for the superiority of the ungloved hand, but the mind and the heart know it is so. Ask any nurse. Ask any patient. Ask anybody who loves the patient and observes the interaction.
 
Henry Schneiderman
Bloomfield, Connecticut

Comments   

# Pam Mitchell 2016-09-29 19:02
Dear Henry,
Thank you. One of the reasons ( many) I left hospital nursing was because of being told nurses on our psychiatric unit could no longer touch patients.....!
Not braiding their hair, no brushing it, nor giving a hug to an aggrieved patient. My supervisor was a social worker to whom I responded that mine was one of the few professions licensed to touch. I also told her she could not define my practice. I resigned. Now I have my own practice where I use common sense as well as the plethora of evidence regarding the healing power of touch. Kudos to you!
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# Dr Kavitha Karur 2016-06-17 04:57
Dear Henry Schneiderman, hands can become colonised with deadly bacteria like MRSA especially in health care providers. Use of gloves in the situation you have described is more for the benefit of your patient than for the internal medicine resident. Multi drug resistant bacteria cause a significant proportion of avoidable mortality and morbidity in todays health care. And if gloves are worn, as an infection control officer, I would encourage the practice.
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# Henry Schneiderman M 2016-07-01 21:52
Dr Karur,
Infection control is important, but not every patient represents a microbial threat. And every patient desperately needs human contact and reassurance. My essay is not meant to be pro-infection but rather pro-touch.
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