The power of touch | Tzipi Strauss | TEDxTelAvivUniversity

Dr. Strauss presents the importance of human touch, emphasizing the importance of it at her Neontology department in the hospital. When Dr. Strauss approaches frightened and excited mothers at the maternity ward, she knows exactly what they need to hear, as a mother to five children herself.
Produced by Gilad Adin http://www.giladadin.com/

Dr. Tzipi Strauss serves as Chief of Neonatology at Sheba Hospital and lectures at Tel Aviv University’s faculty of medicine. She studied at the Technion, Holland, and Harvard. Dr. Strauss is a mother to five children. We wouldn’t bother noting this unless we heard that this piece of information is going to have a crucial part in her talk that will leave us all in tears.

This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at http://ted.com/tedx

When was the last time
you had human contact?

And I'm not talking about sex necessarily.

I'm talking about human touch,

such as a hug from your grandparents,

or a smile from your neighbour,
or a kiss from your child.

Scientists claim that there
are three basic needs in order to survive.

We need oxygen, food, and water.

And I want to suggest
a fourth one, which is touch.

And I will tell you a personal story,
how touch became so important to me.

I have five children.

My first are twin boys.

During their delivery
there were certain complications,

and Rotev, who is my second one,
was born without a pulse.

He underwent resuscitation

and was immediately moved
to the neonatal intensive care unit.

It all happened very fast.

I didn't have time to see him,
not to mention hold him.

Only after 36 hours we finally met.

I vividly remember
entering the department,

approaching the incubator,

and there he was, so tiny and fragile.

I wanted so much to touch him.

So the nurse took him gently
and put him in my arms.

I remember looking at him
and he felt uncomfortable.

His eyes were full of fear,
his heart rate was fast,

his breathing was shallow,
and he looked restless.

And it took a few moments
until he started to relax.

His heart rate decreased,
and he felt much more calm.

And I was trying to think,
"What just happened in the last moments?"

And then it occurred to me
that the last 36 hours

he endured a battery of tests,
examination, pinprick needles.

He was handled,

but not even one time
it had a loving touch.

I felt that it was not only my presence,

but also my touch that created the change.

And only 48 hours later
we got the permission to go home.

So I felt it then as a mom,
and I know it today as a physician,

touch can heal.

So I became a paediatrician
and my specialty is premature babies.

I am the director
of the Neonatal Department

in one of the leading hospitals
in our country,

and the biggest in the Middle East.

And it's a beautiful profession.

I mean, we create life.

We bring a one-pound baby
to grow into a 100-pound person.

It's really amazing.

Prematurity is a baby
that's born before 37 weeks,

or before the eighth month of pregnancy.

And we treat extremely small babies,
even less than one pound.

They are extremely vulnerable.

All their vital organs are not developed,
especially their lungs,

and we give oxygen through
mechanical ventilation.

We give food and water through IV lines.

And we succeeded to decrease mortality
in the last decade.

However, we still have many complications,
especially neurodevelopmental ones,

and we try to improve our outcome.

And I always say that when we try
to improve something in the future,

we have to go back to our past,
to go back to our basics.

And what are our basics?

Our basics is what I call the 3 C's:

It's contact, connection, and compassion,
and I will elaborate.

I remember one day,
walking in the department,

I saw a mom sitting near the incubator,

and she just had twin girls,
33 weeks, two pounds each,

and she was sitting very distant
from the incubator.

And I approached her and I asked her,
"Why aren't you touching your girls?

Why don't you have
skin-to-skin contact with them?"

And she said, "I don't know.
They are so small.

And all these pipes
and the tubes out of them,

and I'm afraid that if I touch them,
I'll get connected,

and they might not survive."

I told her, "Your touch
can help them survive."

Just recently there was a publication
from Harvard University,

claiming that the skin-to-skin care
for low birth weight

reduced mortality in 36 percent.

That's not a small number.

What happens medically when we touch?

When we are being touched,
there is a release of oxytocin.

It's a hormone.
We call it the 'bonding hormone'.

When oxytocin is released,

cortisol levels decrease,
heart rate decreases,

and we feel much more trust and secure.

When being touched,
we feel less pain and less stress.

For the mom, skin-to-skin care
enhances her breast milk production.

And when pre-terms are being touched,
it improves their weight gain.

And I think it's the only time in our life
we are very happy gaining weight.

So she listened carefully
and she started to touch her girls,

and to have skin-to-skin
contact with them.

And they are five years old now,
and beautiful girls.

(Applause)

But contact is not only physical.

We need to create connection.

We need our second C.

And there is a joke about our profession
that we are like veterinary medicine,

both of us do not really speak
with the patients.

And that's true,

we don't really communicate
with the babies and with the children,

but we do have our parents,

and the parents are our patients as well.

Parents are overwhelmed
with the situation they are in.

Suddenly they have a baby;
before time they didn't plan it.

They spend weeks and months
in our department.

And sometimes
in life-threatening situations,

and they are in
extreme anxiety and stress.

And we need to treat them
and to help them,

because lowering their anxiety
helps the outcome of their baby.

I remember talking to parents a few hours
after the delivery of their child,

and I explained to them
about health issues

and what to expect in the next few days.

And they listened quietly
and nodded with their head.

Two days later, during morning round,
I saw them again,

and I asked the mom if everything is okay,
"Do you have any questions?"

She looked at me and she says,

"I don't know; nobody explained
anything up till now."

And I was in shock.

I was thinking in my head,
what does she mean, nobody explained?

It was me!

I explained everything two days ago!

And then I realised that she was right.

I didn't explain it properly.

I didn't create the connection.

I'm sure each one of you was at least
one time in the physician's office.

And it's always the same.

We enter into the doctor's,
we explain about our symptoms,

explain about what kind
of medication we need to take,

in a perfect monologue.

And then when he asks
if we have any questions,

we get into this mental freeze.

We just nod with our head,
and we go out.

And five minutes after we go out
from the clinic,

we remember we forgot to ask
so many questions about side effects,

and actually 50 percent
of what he said, we forgot.

So we, as physicians,
need to explain things properly.

We need to create the connection
and to give our full attention.

So we decided to change things
in our department,

to have a new approach.

For example, we don't speak
with the parents near the incubator

or while handling the baby.

We take them to a quiet room.

We listen to their concerns.

We give them our full attention.

And at the end,
we added the question:

"What did you understand from all that?"

We also wanted to continue the contact
even when they're not in the department.

So we text them an SMS update.

Every morning at nine o'clock
they get an SMS regarding their child.

For example, "Your child is in room six.
His last weight is 1.7 pounds.

He finished all the bottles
and we need more breast milk."

And the results were amazing.

Parents felt much more reassured,

more confident.

They felt that we are available.

They had less anxiety and stress.

And actually, they felt that we care.

We created contact and connection,

and they felt our compassion.

We have the Levine family.

They come every year to celebrate
Daniel's birthday with us.

Daniel was a 24-week preterm,
extremely small,

had many, many complications.

The parents spent a month
in our department.

And every year, they come.

Mr Levine tells me,
"You know, Dr Strauss, I want to tell you

from the whole time we were here,

the main thing I remember
is the day Daniel was born.

I remember you and the team
rushing off to the delivery room.

Then he was in the incubator.

I joined you towards the department,
and suddenly you stopped,

you looked at me with a smile,
and you told me, 'Congratulations.'

And at that moment,
I understood that I am a father.

For better or worse, I am a father.

And it gave me hope."

So words created connection.

Unfortunately, not all
our preterms survive.

And sometimes during
the last day or moment,

parents have to disconnect.

We had one situation when a baby,
after an extremely difficult delivery,

did not survive and died after four days.

I remember the parents,
Sharon and her husband,

were not in the department
on the last day,

and I went outside to talk to them.

And I asked Sharon,

"Please, why don't you come
and say goodbye to your child?"

And she said,
"I cannot. It's too painful."

And I told her,

"I know it's the most difficult situation
I'm asking you to be in,

but it's extremely important
that you come and say goodbye to him."

And at the end she did.

And she came,
and we let her hold her baby,

and she sat there for a few moments,
saying goodbye to him.

Two years later, I got a call
from the maternity ward.

Someone wanted to see me.

So I came there,
and suddenly I saw Sharon.

And she just had a new baby.

And it was very emotional for both of us.

And she hugged me, and she said,

"I want to thank you all for insisting

that I will say goodbye
to my child two years ago,

because only like that
I could close that door

and continue on with my life.

And now I have a perfect, healthy child."

Touch can heal.

And we create contact.

And it's from a mother to her child,

from a physician to a patient,

from one person to another.

Our department is like
a microcosm of the universe.

When we encounter great joy
for bringing new life,

we encounter grief and sorrow
from occasional death,

we have sadness and happiness,

pain and joy, combined together,

and I know every day that I will
have to confront these mixed feelings,

and I cannot do that without compassion.

In our overwhelmed, hectic world,
where technology replaces everything,

it replaces even the essentials
such as oxygen, food, and water.

It cannot and will not replace compassion.

And we need compassion in this world.

Aren't they beautiful, these children?

We all feel compassion for babies.

We all want to hug and kiss them.

But somewhere, along our life course,
we forget this feeling.

And we need to go back to this feeling
of compassion for children.

We need to go back to our basics.

We need to go back to the contact,
connection, and compassion.

And we need to start with contact.

And don't misunderstand me,

I'm not saying you have to touch
every person that you see on the subway.

Contact means a tap
on the shoulder of a friend,

a high five to your colleague,

looking up from our computer,
and laptop, and cellphone,

and creating eye contact,

and smile.

So we create contact and connection,

inevitably we will have compassion.

So we can start today,

right here, right now.

Ask yourself every day:

Did I have any connection with others?

Was I present?

Did I give my full attention
to my mom, my friend, my child?

Because remember, your touch and smile
can create all the difference to them.

Thank you.

(Applause) (Cheers)