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The Power of Touch…
One doctor’s account of the war in Iraq

One doctor’s account of the war in Iraq For reasons incompletely understood by medical science; a warm touch from another person can bring healing power.

There is a familiar song lyric from Counting Crows that goes “you don’t know what you’ve got till it’s gone,” and I never found that lyric to be as true as when I spent time in Iraq with the US Army Medical Corps. As a 90-day boots-on-the-ground Reserve physician, my time there was short, but all my senses had to undergo a fundamental overhaul while in that country. My sense of smell was hampered because my nasal passages were too often full of dust and sand, and my eyes had only barren brown landscape on which to gaze. Despite those notable losses, my sense of touch, human touch, was remarkably heightened by my experiences in the combat zone.

The human hand is an amazing sensory tool. In fact, there are some 17,000 nerves of tactile sensation in that area with each fingertip sports about 100 touch receptors – far more per square inch of skin than on any other body part. Unfortunately, there are more pain nerve endings in our body than any other type, but for reasons incompletely understood by medical science; a warm touch from another person can bring healing power.

Nocioceptors are part of pain nerve fibers that detect actual tissue injury and relay that information to the spinal cord and then on to the brain very quickly through a gatekeeper or filtration system. They are found most abundantly in areas of the body that are more prone to injury including hands and feet. When nocioceptors detect a harmful force such as crushing your fingers in a door, an electrical impulse is generated to start the flow of information, and we are all aware of how fast we can shout an expletive after smashing our fingers – almost instantaneously. If the injury is less catastrophic, the filter or gatekeeper cells may lessen the response somewhat. That is one reason that lightly massaging a recently injured area helps ease the pain - the light massage suppresses to some degree the intensity of the pain signal.

In response to the injury, the brain releases natural pain killer substances such as endorphins and enkephalins that are morphine-like and help decrease the pain pharmacologically. However, there are additional factors that influence our pain including our emotional state at the time of the injury and past pain experiences among others. It is in those areas that simple human touch can make a difference in healing the body.

At our hospital, a therapy dog named Boe was often brought around to visit the patients. Boe had a sweet disposition that invited touch from caregivers and patients alike. I never missed an opportunity to pet Boe when she visited our clinic.
The perceived benefits of massage therapy for chronic pain, stress, and anxiety are well known even though clinical studies to document a true medical benefit are lacking. Still, the potential risk of having massage therapy for any given condition is low, so there is minimal downside to trying it. Even in Iraq, there was some access to massage as a spa treatment for military service personnel and contractors living and working in protected areas; and medical message therapy was available in the combat support hospital setting to some degree. This was clearly helpful to assuage the relative sensory deficit that the austere environment engendered.

Beyond the more formal massage opportunities, I found that as a physician, the simple act of touching another fellow human being for comfort and consolation has value beyond our capacity to understand its power despite having worked out the science of pain pathways. Control of anxiety particularly comes to mind when I recall my Iraq experiences. In addition to human touch, petting an animal as therapy has proven benefit. At our hospital, a therapy dog named Boe was often brought around to visit the patients. Boe had a sweet disposition that invited touch from caregivers and patients alike. I never missed an opportunity to pet Boe when she visited our clinic.

On one occasion, I was attending a pregnant Iraqi woman who had suffered burn injury to her face and neck. Since I had limited capacity to communicate directly with her through an interpreter, one of my main goals in visiting with her in the hospital each day was to use the power of touch to communicate reassurance. I purposefully grasped her hand in mine while speaking to her and her husband through the linguist. Placing my hand on her abdomen to feel the unborn baby was another daily act of comfort. We did have a rudimentary portable ultrasound device available, and that allowed me to show her that her baby was just fine. And each day, we listened to the baby’s heartbeat together using the Doppler device. I believe that these small gestures have the capacity to heal beyond the confines of wound care and surgery as evidenced by the smiles she gave me in return.

There were numerous times during my brief tenure in that combat zone when medical science failed to meet all the needs of the patient, particularly the psychological needs. It was at those times that simply lending an ear and holding a hand became my primary therapy. Here at home, where I have all the state of the art tools for diagnosis and treatment of illness, I did not realize how powerful and important a healing role touch plays. Looking forward, I will make every effort to use that power with each patient I see in every setting.

On the long plane ride back home, there continued to be moments of stress and anxiety that overwhelmed me. I should have felt nothing but joy at the prospect of returning to my family and being able to smell and taste and see colors again, but instead, I felt lost. The emotional pain of leaving behind unfinished business and newly made friends got the best of me. As luck would have it, I was sitting next to a fellow physician who understood the power of touch and recognized my stress. When her hand slipped into mine for a brief moment of reassurance, I felt that electrical impulse heading through those nerve pathways to my brain…and I found the healing I needed.

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"The Power of Touch…
One doctor’s account of the war in Iraq"

   authored by:
GYNECOLOGY
Dr. Jacqueline Thompson is a Board Certified Obstetrician and Gynecologist and Fellow of the American College of Obstetricians and Gynecologists. Formerly an active duty Army doctor, she is now a full time civil service staff physician at Womack Army...



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