While the “power of touch” is a key aspect of osteopathic medicine, its practicality transcends that of its function as a noun. Indeed, touch is a physical contact between one or more surfaces, but it is also transmitted by non-physical means. Touch is so crucial in osteopathy because it can be used in diagnosis and treatment, especially when applying principles of osteopathic manipulative treatment and while compounding as a method to communicate with the patient and better understand the underlying condition.
The art of touch whether physical or non-physical is a skill that will take many, many years of practice and will be continuously refined throughout the career of osteopathic physicians. However, I have recently come to realize that the concept of touch is best exemplified by the musicianship of piano playing and I have used this analogy in my study of osteopathic manipulative treatment as a first year medical student.
In terms of physical touch, there are different degrees and levels of contact. We can simply put our hands on the patient to touch them and do our examinations. We can simply lay fingers on the piano and produce a sound. But when we begin to analyze just how we put our fingers on the piano, this produces more than just a sound- it creates more specific sounds, tones, volumes, colors: music. When putting your fingers on the piano, there are more variables than one might imagine. Just in the first note, there is so much to consider. The pianist must consider the attack- how does one approach the keys? In a shy, quiet piece of music, the fingers must slowly and sneakily slip onto the keys; in a boisterous fanfare piece, the fingers must quickly and boldly strike the keys. In essence, in the simple act of putting hands on the piano keys for the opening note, we have already considered, speed, attitude, and force in just that one touch.
Such thoughtful touching is similarly applied in osteopathy. It is possible for the physician to lay his or her hands on the patient with a coordination of speed, attitude, and force. The result is that this becomes more than a touch and can be sensed by the patient. Not only does sincerity convey a more comfortable environment for the patient, but it also establishes a sense of trust towards the physician. This closer connection improves doctor patient communication and relationships. Putting thought into physical contact also prepares the physician; the act of thinking about the contact stimulates a patient centered approach. Even before touching the patient, the physician would have already considered the general state of the patient while determining the components of the first approach to touching the patient. The physician will have evaluated whether to approach the patient more lightly or with more boldness. I believe that this consideration and thoughtfulness in the initial approach to the patient best sets the stage for patient care. Perhaps if physicians do not consider as much, they will simply lay their fingers on the piano and produce a sound that is not music.
Featured image:
Piano Solo 2 by j_arlecchino
