In the wake of the shootings of Rep. Gabrielle Giffords and 18 others in Tucson, The ABC News Medical unit polled over 100 doctors today to get their expert responses to the idea that human interaction and the presence of family and friends can aide people's recovery efforts. Below is a selection of their answers.
"Yes — It's Proven"
• David Spiegel, Professor and Associate Chair of Psychiatry & Behavioral Sciences at Stanford: "Numerous studies have shown that social isolation is associated with increases in all-cause mortality risk to the same degree as smoking or high cholesterol levels. Individuals tend to die after rather than before their birthdays and major holidays, suggesting some ability to postpone death for a short period to reach a meaningful goal. Conversely, depression and the associated social withdrawal/alienation is an independent predictor of shorter survival with cancer and heart disease… We are social creatures, and we manage stressors better when we are not alone with them"
• Redford Williams, Director, Behavioral Medicine Research Center at Duke: "Back in 1992 we published a paper in JAMA that clearly documented this, showing that heart patients with a spouse, a confidant or both had a 5-year mortality rate of only 18 percent, compared to only 50 percent in those with neither spouse nor confidant."
• Brian Olshansky, Professor of Medicine, University of Iowa Hospitals: "I think there is a whole wealth of data supporting the importance of human connections for healing and recovery form trauma… The data relate to many conditions and health is intricately connected to a sense of well being and connection to the family, to people in general, to friends and to nature. There is even some evidence that prayer can help connect people and make them healthier but there is a discrepancy on this."
• Michael A. Grodin, Professor of Bioethics and Human Rights, Boston University School of Public Health: "This is nothing new…as clinicians we see a clear connection between mind and body...there is no question in my 33 years of medical practice that support systems and positive belief impacts on recovery."
"Yes -- I Believe it but Do Not Know if There Is Evidence"
• E. Antonio Chiocca, M.D., Ph.D., Chairman of Department of Neurological Surgery, Ohio State University: "There isn't foolproof hard evidence, but I think that the presence of loved ones actively involved does provide an increased stimulus that may accelerate recovery. However, it is difficult (probably impossible) to prove."
• Daniel F. McCarter, Associate Chief Medical Officer of Ambulatory Services University of Virginia Health System: "There are some studies showing benefits of modalities such as touch and intercessory prayer. I have certainly seen some instances where having family nearby seems to make a huge difference for the patient. However, ultimately this is similar to religion and the reason they call it faith rather than proof."
• David G. Standaert, Director, Center for Neurodegeneration and Experimental Therapeutics at the University of Alabama at Birmingham: "My experience with patients leads me to believe that the involvement of friends and family can accelerate recovery. From a neurobiological perspective, I think this can be viewed as a kind of "environmental enrichment," a concept which does have a solid basis in experimental science."
• Jonathan S. Abramowitz, Professor and Associate Chair of Psychology at the University of North Carolina: "I don't know if there are data, but people who are socially isolated, I would believe, would recover more slowly (on average -- of course, everyone is different) because they might have greater stress, which causes chemical changes in the body that interfere with healing. Having the President of the U.S. at your bedside (provided you are able to even realize he's there), would almost certainly cause chemical changes in the body that would be the opposite of a stress response"
"Family Support Does Not Help"
• Mitchell Roslin, Bariatric Surgeon at Lenox Hill Hospital, New York: "It fills our heart with joy when we hear the story of the Rutgers football player who we thought was paralyzed now showing neurological function. It is probably comforting to recognize a soothing voice when we emerge from sedation. But how much of the progress is due to the football player's mom being bedside? Do the people who improve less, get less love? I think it is more our desire to provide a rationale and control for things that we cannot control"
• Kostas Lyketsos, Director of the Neuropsychiatry Service at Johns Hopkins Medical Center: "From my point of view there is ZERO convincing evidence to support this"
• Art Reingold, Head of the Division of Epidemiology at University of California, Berkeley: "No, there is no credible evidence that prayer or faith or feelings of/by others have any impact on health/cure rates/recovery from any form of illness or injury, much as many people 'of faith' would like to believe."
Doctors' experiences with the power of family support and touch…
• Harley A. Rotbart, Professor and Vice Chairman of Pediatrics, University of Colorado: "The first 'miracle' I witnessed was as a resident. Two young brothers, ages 3 and 7, were brought into the emergency room and then the intensive care unit at Children's Hospital of Philadelphia after near-drowning episodes. It was winter, and the 3 year had fallen into a swimming pool with enough residual water that he couldn't stand.
"His 7-year-old brother jumped in, pulled the younger boy to one of the pool's steps where the 3-year-old's head was out of the water, but the 7-year-old was then himself overwhelmed by the freezing water and couldn't get out before submerging.
"When paramedics arrived, both boys were unconscious. In the ICU, the younger boy regained consciousness within a few hours and was neurologically normal. The older brother remained in a coma for weeks. The family stood vigil every day, and the residents took over in the evenings and overnight, holding the older boy's hand, talking and singing to him.
"We all prayed. Not in an organized way, or even in a traditional way, but each of us in his or her own way. It was on my 'watch,' late at night when I felt the 7-year-old squeeze my hand while I was reading to him. Just once. By that time, weeks into his stay in the ICU, discussions were beginning about discontinuing support, brain death, etc. I told everyone on rounds the next morning about the hand squeeze. Most of my colleagues and supervisors attributed it to involuntary muscle spasms.
"But then someone else felt it that morning, and then again that afternoon, now in response to 'command.' It was several more days before he opened his eyes, and a few hours after that before he smiled, still with an endotracheal tube in place. When he walked out of the hospital more than 2 months after the near-drowning, and his heroic rescue of his brother, we all cheered and cried. We had cried many times in the weeks preceding, and I still cry whenever I tell this story."
• Jay Wolfson, Director, Suncoast Center for Patient Safety, Evaluation and Research, University of South Florida: "When I served as the special guardian for [Terri] Schiavo, I spent a great deal of time with Michael, her husband, and Mary and Bob, her parents, and had each of them with me often when I spent hours with Ms. Schiavo. Both sides firmly believed that their presence with her made a profound difference in her state."
• Dan Blumenthal, Chair of the Department of Public Health at Morehouse School of Medicine: "My wife once told me that if she were ever in a coma in the hospital, I should stand at her bedside and talk to her, because she thought the sound of my voice would reach her and help her recover.
"As it happened, a couple of years later she was in a coma in the hospital, and I did stand at her bedside and talk to her. When I ran out of things to talk about, I read poetry to her. This went on for hours every day. It didn't help. She died anyhow. So I guess I'm not a believer in the loved-ones-at-the-bedside theory ... but a [sample size] of 1 isn't science."
• Derek Raghavan Oncologist, Cleveland Clinic: "I have a classic tale of Andrew, a Scot living in Sydney, with no family at all, and no friends...was dying of lung cancer, and pain management was a huge issue...on evening rounds, when I was still only a fellow, I sat on his bed, and asked about what terrified him the most....he responded that it was his fear of being buried with nobody to 'send him off' -- I responded by telling him that my chief nurse, my resident and I would form his funeral party -- he had an almost instant turn-around, leading to a much more comfortable and peaceful death, and we did, as promised, hire a vehicle, follow the hearse, and participated in his burial....gratifying for him and surprisingly gratifying for each of us as we still occasionally speak of it (and him) 25 years later."
• Lillie D. Shockney, R.N. Associate Professor, Johns Hopkins School of Medicine: "The last sense we lose before dying is our sense of hearing. Many patients have told me that they could hear their mother, spouse, sister telling them to keeping fighting and to hold on and that it did inspire them to fight the fight needed to recover. They couldn't open their eyes or communicate to the family member but was thankful for their presence and expressions of love."
• Charles Clark, diabetes specialist, Professor of Medicine at Indiana University: "I have taught the importance of touching throughout my decades of teaching medical students and residents. When I first see a patient and subsequently I always make physical contact.
"While we have advanced the science of medicine dramatically over the past decades, we have all too often lost sight of the art of healing; this is especially true when we have nothing miraculous to provide a person with a chronic or incurable disease or like Gabby who must do their healing on their own.
"We are increasingly teaching our students the art of what is called Narrative Medicine, sharing of ourselves with patients. Touch is part of that, and is increasingly being shown to be of objective value. "But all you really need to be assured that touch is part of healing is to look back at a time when you were suffering or grieving and were touched by a person who cared about you."
• Bryon Petersen, Associate Professor, Department of Pathology, University of Florida: "I have seen patients cured using placebos and seen the power of prayer cure patients. Long care facilities use pets to help patients stay somewhat active; the mind is a black hole we know very little about. Are these acts of 'miracles'? Who knows, really who cares? All that matters is the patient is feeling better or cured."
• Christopher A. Ohl, Associate Professor of Medicine, Wake Forest University: "Another experience that I have had repeatedly (including with my own mother) is that a loved one who is expectant and dying will die very soon (minutes to a few hours) after a visit from an out-of-town loved one or relative; as if waiting to say good-bye."