Forms of Touch during Medical Encounters with an Advanced Heart Failure (AdHF) Doctor who Practices Relational Medicine
Keywords:Caring touch, Relational medicine, Caring for the other, Death as part of living
Within a participatory research project, we investigate how forms of touch we call caring touch are enacted in AdHF medical encounters. Through the theoretical lens of Relational Ontology (Raia, 2018), grounding multimodality in phenomenology, we identify various forms of caring touch. When occurring in conjunction with medical/diagnostic touch, especially in situations of a perceived patient’s vulnerability, caring touch facilitates passages from the person level to the organ, tissue, and gene levels and then back to the whole-person level in an uninterrupted movement, maintaining the person-person relation between doctor and patient. Gentle shepherding (Cekaite, 2010) is used to guide the patient body, and comforting touch (Goodwin & Cekaite, 2018) accompanies invitations to enter a space where death is part of living. We show the existential grounding power of caring touch, which constitutes forms of reciprocal sharing of existential experiences in caring-for-the-Other. All these forms of caring touch are employed by an AdHF doctor whose work centers on the practice of Relational Medicine (Raia and Deng, 2015b), in which the starting and returning point is the patient in his/her life. While providing a single case analysis, the research builds from a corpus of 500 hours of recorded medical encounters with 125 patients in high-tech medicine.
Beach, W. A. (2018). Making Cancer Visible: Unmasking Patients’ Subjective Experiences. Health Communication, 1–14.
Blattner, W. D. (2005). Temporality. In H. L. Dreyfus & M. Wrathall (Eds.), A Companion to Heidegger (pp. 311–324). John Wiley Sons.
Cekaite, A. (2010). Shepherding the child: Embodied directive sequences in parent–child interactions. Text & Talk - An Interdisciplinary Journal of Language, Discourse & Communication Studies, 30(1), 1–25.
Dreyfus, H. L. (1991). Being-in-the-world: A Commentary on Heidegger’s Being and Time, Division I. MIT Press.
Freeman, W. J. (2000). How Brains Make Up Their Minds. Columbia University Press.
Goodwin, C. (1994). Professional Vision. American Anthropologist, 96(3), 606–633.
Goodwin, C. (2018). Co-Operative Action. New York: Cambridge University Press.
Goodwin, M.H. (1980). Processes of Mutual Monitoring Implicated in the Production of Description Sequences. Sociological Inquiry, 50(3–4), 303–317.
Goodwin, M.H. & Cekaite, A. (2018). Embodied family choreography: Practices of control, care, and mundane creativity. London: Routledge.
Greco, L., Galatolo, R., Horlacher, A. S., Piccoli, V., Ticca, A. C., & Ursi, B. (2019). Some theoretical and methodological challenges of transcribing touch in talk-in-interaction. Social Interaction. Video-Based Studies of Human Sociality, 2(1).
Heidegger, M. (1962). Being and Time (J. Macquarrie & E. Robinson, Trans.). Oxford: Blackwell Publishing.
Hertenstein, M. J. (2002). Touch: Its Communicative Functions in Infancy. Human Development, 45(2), 70–94.
Levinas, E. (1979). Totality and Infinity: An Essay on Exteriority. Springer Science & Business Media.
Lutfey, K., & Maynard, D. W. (1998). Bad News in Oncology: How Physician and Patient Talk About Death and Dying Without Using Those Words. Social Psychology Quarterly, 61(4), 321.
Mauthner, O. E., De Luca, E., Poole, J. M., Abbey, S. E., Shildrick, M., Gewarges, M., & Ross, H. J. (2015). Heart transplants: Identity disruption, bodily integrity and interconnectedness. Health, 19(6), 578–594.
McArthur, A. (2018). Getting pain on the table in primary care physical exams. Social Science & Medicine, 200, 190–198.
Merleau-Ponty, M. (1962). Phenomenology of Perception (C. Smith, Trans.). London: Routledge & Kegan Paul.
Meyer, C., Streeck, J., & Jordan, J. S. (Eds.). (2017). Intercorporeality: Emerging socialities in interaction. New York, NY: Oxford University Press.
Mondada, L. (2011). The Organization of Concurrent Courses of Action in Surgical Demonstrations. In J. Streeck, C. Goodwin, & C. LeBaron (Eds.), Embodied interaction: Language and body in the material world (pp. 207–226).
Nishizaka, A. (2011). The embodied organization of a real-time fetus: The visible and the invisible in prenatal ultrasound examinations. Social Studies of Science, 41(3), 309–336.
Nishizaka, A. (2017). The Perceived Body and Embodied Vision in Interaction. Mind, Culture, and Activity, 24(2), 110–128.
Ochs, E., & Capps, L. (2001). Living Narrative: Creating Lives in Everyday Storytelling. Harvard University Press.
Raia, F. (in press). Temporality of Becoming: Care as an Activity to Support the Other Develop a Sense of Self. Mind, Culture, and Activity.
Raia, F. (2018). Identity, tools and existential spaces. Learning, Culture and Social Interaction, 19, 74–95.
Raia, F., & Deng, M. (2015a). Is relational medicine the key to providing truly personalized high-tech modern medicine? Personalized Medicine, 12(1), 5–7.
Raia, F., & Deng, M. (2015b). Relational Medicine: Personalizing Modern Healthcare: The Practice of High-Tech Medicine as a Relational Act. London: Imperial College Press/World Scientific.
Rindstedt, C., & Aronsson, K. (2012). Children’s Intent Participation in a Pediatric Community of Practice. Mind, Culture, and Activity, 19(4), 325–341.
Sacks, H. (1995). Lectures on Conversation II. Cambridge, MA: Basil Blackwell.
Schegloff, E. A. (1987). Analyzing Single Episodes of Interaction: An Exercise in Conversation Analysis. Social Psychology Quarterly, 50(2), 101–114.
Shildrick, M., McKeever, P., Abbey, S., Poole, J., & Ross, H. (2009). Troubling dimensions of heart transplantation. Medical Humanities, 35(1), 35–38.
Sterponi, L., Zucchermaglio, C., Fatigante, M., & Alby, F. (2019). Structuring times and activities in the oncology visit. Social Science & Medicine, 228, 211–222.
Stivers, T., Mondada, L., & Steensig, J. (2011). The Morality of Knowledge in Conversation. Cambridge University Press.
Streeck, J. (2009). Gesturecraft: The manu-facture of meaning. John Benjamins Publishing.
Streeck, J., & Mehus, S. (2005). Microethnography: The study of practices. In K. L. Fitch & R. E. Sanders (Eds.), Handbook of Language and Social Interaction (pp. 381–404). Mahway, NJ: Lawrence Erlbaum Associates Publishers.
How to Cite
Copyright (c) 2020 Author and Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
We follow the Budapest Open Access Initiative's definition of Open Access.
The journal allows the author(s) to hold the copyright without restrictions.
The journal allows software/spiders to automatically crawl the journal content (also known as text mining)
The journal provides article level metadata to DOAJ
The journal allows readers to read, download, distribute, print, search, or link to the full texts of its articles and allow readers to use them for any other lawful purpose.