Four-handed care

by Rev. Paul L. Escamilla, Senior Pastor

       Our oldest daughter, Sarah, is a physical therapist on a cardiac care unit at Texas Children’s Hospital in Houston. I am both intrigued and often deeply stirred to learn of the ways she applies the healing arts with fragile and often very sick children. She recently shared with me an emerging approach to treatment of pediatric heart patients—many of whom are very small, and very vulnerable—called four-handed care. The approach is in some ways quite intuitive, and yet is just now being clinically annotated.

Four-handed care is based on clinical trials which demonstrate (bear with me now—I’m a layperson in this field!) that fragile children with delicate medical issues respond better to direct interventions by a nurse or therapist, such as changing a dressing, turning the child, suctioning, or any of the myriad other prodding, poking, pricking procedures prescribed in treatment, when a second caregiver simply places their hands on the child during the procedure. Studies have shown, for example, that an infant’s heart rate, predicted to spike during and immediately following such a procedure, often showed less elevation when four hands were involved rather than only two.

While one pair of hands is busy about the careful but sometimes distressing work of treatment, another pair of hands gently cradles a tiny head or lightly rests on little shoulders. Nothing more. The simple placement of that second pair of hands on the child can result in small wonders. Is it the tactile sensation? The warmth? Some other kinetic, emotional, or spiritual field? I know this: when I’m in a difficult situation, what I most appreciate from another is not just a way out, but understanding and a way out; not just logic, but love to go with it.

When Jesus said, “Where two or three are gathered together, there am I” (Matthew 18:20), I wonder if he had four-handed care in mind; that church really starts getting good when we come together in partnerships: one lends a hand, and another holds a hand; one builds, and another blesses; one does the books, or the set-up, or the flow chart, and another does the connecting, the listening, the simply being present at another’s side. And . . . switch.

When I consider all we are at Laurel Heights, all the expressions of our shared ministry, the variety of our gifts, the multitude of ways we are in ministry, I’d say we are in our own way confirming the latest research on how best to love: with both tasks and touch; responsibilities and relationships to give them meaning and purpose. I am grateful for both in you, and in our life together.

Grace and peace,

Paul