Tuesday, April 04, 2006


Day 4:

Hands: it's surprising how much they can say about people. You meet a new patient, you shake his hand. After finishing your history and physical, you leave the room the same way. And in the time in between these two grasps, what a patient does with his or her hands (and what you do with your own) says a lot to the other person about who you are and what you're feeling and thinking.

From the moment your palms meet one another's, each person begins to size up the other; you get a sense of who exactly it is staring back at you. Is their skin hard and calloused from a long life of toil and labor or is it softer, daintier? Does the grip try to sap each ounce of strength from your own mitt, as though your hand was but a washcloth needing to be wrung out? Or is the grasp barely a flopping of the wrist? How long does it last? Two hands or one? Each question sheds some small ray of light on who we are and where we've been.

Some patients keep their extremities hidden under the safety of their bed sheets, staring up at you like children newly tucked in for the night. Others fall at the opposite extreme, gesturing excessively and emphatically in an effort to get some point across to you. "It hurts here, doc," wouldn't have quite the same effect if the statement was missing the accusatory aim of an index finger directed at the offensive body part.

You see the cut-up hands, dirt and grit beneath the fingertips, of the man brought in by the police, his big, worn paws now shackled to the bed railing. You see the purple nail polish, complete with white smiley faces, on the fingernails of the 29 year old woman with lupus, her skin ravaged by an autoimmune disease process that you can do little about.

You see the medical student's hands, filled with charts and order sheets, constantly sifting through the pages in a hurried search for some lab value hidden therein. You see the old woman - the one who just lost her son - wring her hands over and over and over again, left through right, right through left, again and again. And again. She does the same with her feet, a constant massage of one with the other, emotional energy leaving her grief-stricken body in whatever way it can.

You wish that she would stop this endless squeezing and straining, but then you notice you're running your fingers through one another in just the same pattern.

Lesson learned: we speak with our whole bodies, hands down.


At 8:25 AM, Blogger sarj√© said...

Beautifully written, Lucas!


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