Catherine Humikowski is a pediatric intensive care physician who survived a cardiac arrest on the day her daughter was born.
There is an imaginary line that separates doctors from patients. Have you ever tripped over it? I have.
To practice medicine with compassion—as human beings caring for other human beings who also suffer, grieve, ache, heal, and die—physicians must examine this line, question it, and sometimes deliberately cross it.
In her essay “A Letter to My Younger Self,” which won second place in the 2018 Compassion in Healthcare Essay Contest, Candice Kim writes about stepping over this line. A survivor of child abuse begins her first day of pediatrics residency with a patient whom she recognizes as a victim of abuse: double sweatshirts, hood drawn over downcast eyes, bruises covered with makeup. When the resident inquires about “hard things going on at home,” the patient begins to cry.
The piece opens with a glimpse of the resident’s own history of abuse at the hands of her mother and foster father, including an inflicted cigarette burn under her left clavicle, the scar later assigned by her childhood self to fairy dust. Now as a survivor of abuse on the threshold of her career as a pediatrician, the resident reflects, “The secret to your resilience is actually the thing that feels scariest to you right now: caring for others.”
The resident’s first instinct when the patient begins to cry is toward physical connection, recognizing that even a hug bears its own weight: “You know that sometimes it’s hard to see physical touch as care when it’s been the cause of so much pain. Not everyone wants to be held.” The patient nods permission and the resident embraces her, “making sure not to apply too much pressure because who knows how many bruises there are or how deep they go. You cradle her head against your chest, her left ear right on top of your special fairy dust spot. And you let her tears soak through your white coat, through your shirt, all the way to your skin.”
Physical touch bears special significance in navigating this invisible line between doctors and patients. Medical touch can be painful, cold, frightening. So when touch is used to build connection—the holding of hands, an embrace—it exerts unique power. In my essay “And I Submitted” (Intima, Spring 2023), I recount an experience with a patient’s mother who cradles my pregnant belly in her own two hands as we navigate her son’s diagnosis of brain death after suicide. Like the resident in “A Letter to My Younger Self,” the mother asks permission before touching, acknowledging and honoring the sanctity of each human body.
The ways that doctors connect with patients change as the line between them blurs. The lessons I was taught about how to connect with patients and families—“Pause after speaking. Allow space for silence. Offer a box of tissues?”—came before I was a mother myself, before I lost my own mother, before countless traumas. In writing, as in life, narrative distance changes the story. I wrote “And I Submitted” nearly ten years after it happened, the interval experiences altering my perspective about an acceptable intimacy between doctors and patients. Likewise, the resident in “A Letter to My Younger Self” might not have been able to express such compassion ten years earlier, more proximate to her own history of personal abuse. “Nobody ever said to let a weeping mother cradle my own body in her hands. Was this too close?” I wondered at the time. “No,” I concluded later. “I could have wrapped my whole person around her and it would not have been too close.”
The imaginary line that separates doctors from patients can be protective at times. It allows me to imagine all the ways my own children differ from the children I care for in the pediatric intensive care unit where I practice. The line allows me to do my work. But sometimes this line is a barrier to be crossed. In these moments, physical touch—gently and with permission—erases the line at the point of contact. There is no doctor/patient distinction then, only human beings caring for each other.
Catherine Humikowski is a pediatric intensive care physician who survived a cardiac arrest on the day her daughter was born. She is an honors graduate of the University of Chicago and received clinical training in general pediatrics and critical care medicine at Boston Children's Hospital. She presents nationally on physician burnout and is currently pitching her first book. In addition to writing and speaking, Dr. Humikowski serves as the Wellness Director for the Division of Critical Care at Ann & Robert H. Lurie Children's Hospital of Chicago, where she is an active clinician, educator and peer mentor.