Close-ups

A Patient's Perspective

The Importance of Touch

I have a physician who's almost impossible to see. But when I see him, he sits down, he's there, and I have the sense I have his full attention. I think that the act of sitting down and being on the same level as the other person, having two chairs-these things make an enormous difference.

When you have liver disease, you're being palpated and percussed with some regularity. It's my favorite part of an examination. When I first became a patient, before hepatitis C was an epidemic, there was more percussing going on! Now, it seems to me from experience, doctors do less of that than they used to. In my case, it's partly because of imaging devices and sonograms, and partly because doctors only have time to look at synthetic functions and numbers. There is also the sense that the numbers, the liver enzymes-even for a patient who knows a fair amount about their illness, like me-are inside your body, and this increases your desire for the physician to hear your body, and so in some way to hear your story. I always feel sort of empty at the end of an exam when that has not occurred, because I feel like being seen as a human being has everything to do with being touched.-Richard McCann, 54

commentary

I met Richard McCann, a writer and teacher, at a public reading. He read from his essay, "To Whom It May Concern," a letter to the unknown donor of his liver.1 "Dear donor," he read, "sometimes I feel I love you more than anyone in life. After all, you're life itself to me. Other times, I tell myself this: You're someone who died, that's all. It's sad, it's awful, really, but there's no need to get all false and sentimental. Dear dead zero. Dear no one at all. You died. But not for love of me. Here's a secret: I talk to you all the time." The audience became hushed, and I was transfixed. Since then, I have invited Richard McCann to talk to medical students about his experiences as a patient. Over time, we have developed a cordial friendship. Once in a while, he sneaks in a request: "Can you get me a flu shot?"

CAROLINE WELLBERY, MD

REFERENCES

1. Richard McCann. To whom it may concern. Washington Post Magazine. March 5, 2000.

RESOURCES

Hepatitis C Association
Web site: http://hepcassoc.org
Summaries of latest news articles, general information, message board

HCV Advocate
Web site: http://www.hcvadvocate.org
Newsletter, resources in multiple languages, forms to track physician visits and laboratory tests, community support links

Columbia University Medical Center Hepatitis C Information
Web site: http://cpmcnet.columbia.edu/dept/gi/hepC.html
Information on diagnosis and treatment of hepatitis C

National Hepatitis C Coalition
Web site: http://nationalhepatitis-c.org
Creditable patient-oriented site with stories, chat room, links, and information

The editors of AFP welcome submissions for Close-ups. Guidelines for contributing to this new feature can be found in the Authors' Guide at http://www.aafp.org/afp/authors. Submit patient scenarios via e-mail to afpjournal@georgetown.edu with the heading: Close-ups submission [your last name].

Submissions must include a patient story, commentary, patient photograph, resources, signed patient release form, author statement form, and conflict of interest form. Photographs must meet minimum quality standards (see Authors' Guide for more information).

Close-ups is coordinated by Caroline Wellbery, MD, associate deputy editor, with assistance from Amy Crawford-Faucher, MD, Tony Miksanek, MD, and Jo-Marie Reilly, MD. Questions about this department may be sent to Dr. Wellbery at wellberc@georgetown.edu.