A Natural History of the Senses (12 page)

Although I am not a portly middle-aged gentleman with nothing else to do, I am massaging a tiny baby in a hospital in Miami. Often male
retirees volunteer to enter preemie wards late at night, when other people have families to tend or a nine-to-five job to sleep toward. The babies don’t care about the gender of those who cosset and cuddle them. They soak it up like the manna it is in their wilderness of uncertainty. This baby’s arms feel limp, like vinyl. Still too weak to roll over by itself, it can flail and fuss so well the nurses have laid soft bolsters on its bed, to keep it from accidentally wriggling into a corner. Its torso looks as small as a deck of cards. That this is a baby boy lying on his tummy, who will one day play basketball in the summer Olympics, or raise children of his own, or become a heliarc welder, or book passage on a low-orbital plane to Japan for a business meeting, is barely believable. The small life form with a big head, on which veins stand out like river systems, looks so fragile, feels so temporary. Lying in his incubator, or “Isolette,” as it’s called, emphasizing the isolation of his life, he wears a plumage of wires—electrodes to chart his progress and sound an alarm if need be. Reaching carefully scrubbed, disinfected, warmed hands through the portholes of the incubator with pangs of protectiveness, I touch him; it is like reaching into a chrysalis. First I stroke his head and face very slowly, six times for ten seconds each time, then his neck and shoulders six times. I slide my hands down his back and massage it in long sweeping motions six times, and caress his arms and legs six times. The touching can’t be light, or it will tickle him, nor rough, or it will agitate him, but firm and steady, as if one were smoothing a crease from heavy fabric. On a nearby monitor, two turquoise EKG and breath waves flutter across a radiant screen, one of them short and saw-toothed, the other leaping high and dropping low in its own improvisatory dance. His heartbeat reads 153, aerobic peak during a stiff workout for me, but calm for him, because babies have higher normal heart rates than adults. We turn him over on his back and, though asleep, he scrunches up his face in displeasure. In less than a minute, he runs a parade of expressions by us, all of them perfectly readable thanks to the semaphore of the eyebrows, the twisted code of the forehead, the eloquent India rubber of the mouth and chin: irritation, calm, puzzled, happy, mad.… Then his face goes slack and his eyelids twitch as he drifts into REM sleep, the blackboard
of dreams. Some nurses refer to the tiny preemies, sleeping their sleep of the womb, as fetuses on the outside. What does a fetus dream? Gently, I move his limbs in a mini-exercise routine, stretching out an arm and bending the elbow tight, opening the legs and bending the knees to the chest. Peaceful but alert; he seems to be enjoying it. We turn him onto his tummy once more, and again I begin caressing his head and shoulders. This is the first of three daily touch sessions for him—it may seem a shame to interrupt his thick, druglike sleep, but just by stroking him I am performing a life-giving act.

Massaged babies gain weight as much as 50 percent faster than unmassaged babies. They’re more active, alert, and responsive, more aware of their surroundings, better able to tolerate noise, and they orient themselves faster and are emotionally more in control. “Less likely to cry one minute, then fall asleep the next minute,” as a psychologist, detailing the results of one experiment, explained in
Science News
in 1985, they’re “better able to calm and console themselves.” In a follow-up examination, eight months later, the massaged preemies were found to be bigger in general, with larger heads and fewer physical problems. Some doctors in California have even been putting preterms on small waterbeds that sway gently, and this experiment has produced infants who are less irritable, sleep better, and have fewer apneas. The touched infants, in these studies and in others, cried less, had better temperaments, and so were more appealing to their parents, which is important because the 7 percent of babies born prematurely figure disproportionately among those who are victims of child abuse. Children who are difficult to raise get abused more often. And people who aren’t touched much as children don’t touch much as adults, so the cycle continues.

A 1988
New York Times
article on the critical role of touch in child development reported “psychological and physical stunting of infants deprived of physical contact, although otherwise fed and cared for …,” which was revealed by one researcher working with primates and others working with World War II orphans. “Premature infants who were massaged for 15 minutes three times a day gained weight 47 percent faster than others who were left alone in
their incubators … the massaged infants also showed signs that the nervous system was maturing more rapidly: they became more active … and more responsive to such things as a face or a rattle … infants who were massaged were discharged from the hospital an average of six days earlier.” Eight months later, the massaged infants did better in tests of mental and motor ability than the ones who were not.

At the University of Miami Medical School, Dr. Tiffany Field, a child psychologist, has been studying a group of babies admitted to the intensive care unit of its hospital for various reasons. With 13,000 to 15,000 births a year at the hospital, she never lacks for a steady supply of babies. Some are receiving caffeine for bradycardia and apnea problems, one is hydroencephalic, some are the children of diabetic mothers who must be carefully monitored. At one Isolette, a young mother sits on a black kitchen chair by her baby, reaches a hand in and gently strokes, whispering motherly nothings into its ear. Inside another Isolette, a baby girl wearing a white nightie with pink hearts bursts into a classic textbook wail that rises and pulses and sets off the alarm on her monitor. Across the room, a male doctor sits quietly beside a preemie, holding a two-pronged plastic stopper close to her nostrils, trying to teach her to breathe. Next to him, a nurse turns a baby girl onto her tummy and begins a “stim,” as they call the massage, shorthand for stimulation. They use the word interchangeably as a verb or a noun. What old faces the preemies have! Changing expressions as they sleep, they seem to be rehearsing emotions. The nurse follows her massage schedule, stroking each part of the preemie six times for ten seconds. The stimulation hasn’t changed the baby’s sleep patterns, but she’s been gaining thirty grams more a day and will soon be going home, almost a week ahead of what one would expect. “There’s nothing extra going into the babies,” Field explains, “yet they’re more active, gain weight faster; and they become more efficient. It’s amazing,” she continues, “how much information is communicable in a touch. Every other sense has an organ you can focus on, but touch is everywhere.”

Saul Schanberg, a neurologist who experiments with rats at Duke University, has found that licking and grooming by the mother rat
actually produced chemical changes in the pup; when the pup was taken away from the mother, its growth hormones decreased. ODC (the “now” enzyme that signals it is time for certain chemical changes to begin) dropped in every cell in the body, and protein synthesis fell. Growth began again only when the pup was returned to the mother. When experimenters tried to reverse the bad effects without the mother, they discovered that gentle stroking wouldn’t work, only very heavy stroking with a paintbrush that simulated the mother’s tongue; after that the pup developed normally. Regardless of whether the deprived rats were returned to their mothers or stroked with paintbrushes by experimenters, they overreacted and required a great deal of touching, far more than they usually do, to respond normally.

Schanberg first began his rat experiments as a result of his work in pediatrics; he was especially interested in psychosocial dwarfism. Some children who live in emotionally destructive homes just stop growing. Schanberg found that even growth-hormone injections couldn’t prompt the stunted bodies of such children to grow again, but tender loving care did. The affection they received from the nurses when they were admitted to a hospital was often enough to get them back on the right track. What’s amazing is that the process is reversible at all. When Schanberg’s experiments with infant rats produced identical results, he began to think about human preemies, who are typically isolated and spend much of their early life without human contact. Animals depend on being close to their mothers for basic survival. If the mother’s touch is removed (for as little as forty-five minutes in rats), the infant lowers its need for food to keep itself alive until the mother returns. This works out well if the mother is away only briefly, but if she never comes back, then the slower metabolism results in stunted growth. Touch reassures an infant that it’s safe; it seems to give the body a go-ahead to develop normally. In many experiments conducted all over the country, babies who were held more became more alert and developed better cognitive abilities years later. It’s a little like the strategy one adopts on a sinking ship: First you get into a life raft and call for help. Baby animals call their mothers with a high-pitched cry. Then you take
stock of your water and food, and try to conserve energy by cutting down on high-energy activities—growth, for instance.

At the University of Colorado School of Medicine, researchers conducted a separation experiment with monkeys, in which they removed the mother. The infant showed signs of helplessness, confusion, and depression, and only the return of its mother and continuous holding for a few days would help it return to normal. During separation, changes occurred in the heart rate, body temperature, brain-wave patterns, sleep patterns, and immune system function. Electronic monitoring of deprived infants showed that touch deprivation caused physical and psychological disturbances. But when the mother was put back, only the psychological disturbances seemed to disappear; true, the infant’s behavior reverted to normal, but the physical distresses—susceptibility to disease, and so on—persisted. Among this experiment’s implications is that damage is not reversible, and that the lack of maternal contact may lead to possible long-term damage.

Another separation study with monkeys took place at the University of Wisconsin, where researchers separated an infant from its mother by a glass screen. They could still see, hear, and smell each other, only touch was missing, but that created a void so serious that the baby cried steadily and paced frantically. In another group, the dividing screen had holes, so the mother and baby could touch through it, which was apparently sufficient because the infants didn’t develop serious behavior problems. Those infants who suffered short-term deprivation became adolescents who clung to one another obsessively instead of developing into independent, confident individuals. When they suffered long-term deprivation, they avoided one another and became aggressive when they did come in contact, violent loners who didn’t form good relationships.

In University of Illinois primate experiments, researchers found that a lack of touch produced brain damage. They posed three situations: (1) touch was not possible, but all other contact was, (2) for four hours out of twenty-four the glass divider was removed so the monkeys could interact, and (3) total isolation. Autopsies of the
cerebellum showed that those monkeys who were totally isolated had brain damage; the same was true of the partially separated animals. The untampered-with natural colony remained undamaged. Shocking though it sounds, a relatively small amount of touch deprivation alone caused brain damage, which was often displayed in the monkeys as aberrant behavior.

As I rearrange the preemie in his glass home, I notice that on the walls a bright circus design shows clowns, a merry-go-round, tents, balloons, and a repeat banner that says “Wheel of Fortune.” “Touch is far more essential than our other senses,” I recall Saul Schanberg saying when we spoke, on Key Biscayne, at Johnson & Johnson’s extraordinary conference on touch in spring, 1989, a three-day exchange of ideas that brought together neurophysiologists, pediatricians, anthropologists, sociologists, psychologists, and others interested in how touch and touch deprivation affect the mind and body. In many ways, touch is difficult to research. Every other sense has a key organ to study; for touch that organ is the skin, and it stretches over the whole body. Every sense has at least one key research center, except touch. Touch is a sensory system, the influence of which is hard to isolate or eliminate. Scientists can study people who are blind to learn more about vision, and people who are deaf or anosmic to learn more about hearing or smell, but this is virtually impossible to do with touch. They also can’t experiment with people who are born without the sense, as they often do with the deaf or blind. Touch is a sense with unique functions and qualities, but it also frequently combines with other senses. Touch affects the whole organism, as well as its culture and the individuals it comes into contact with. “It’s ten times stronger than verbal or emotional contact,” Schanberg explained, “and it affects damn near everything we do. No other sense can arouse you like touch; we always knew that, but we never realized it had a biological basis.”

“You mean how adaptive it is?”

“Yes. If touch didn’t feel good, there’d be no species, parenthood, or survival. A mother wouldn’t touch her baby in the right way unless the mother felt pleasure doing it. If we didn’t like the feel of
touching and patting one another, we wouldn’t have had sex. Those animals who did more touching instinctively produced offspring which survived, and their genes were passed on and the tendency to touch became even stronger. We forget that touch is not only basic to our species, but the key to it.”

As a fetus grows in the womb, surrounded by amniotic fluid, it feels liquid warmth, the heartbeat, the inner surf of the mother, and floats in a wonderful hammock that rocks gently as she walks. Birth must be a rude shock after such serenity, and a mother re-creates the womb comfort in various ways (swaddling, cradling, pressing the baby against the left side of her body where her heart is). Right after birth, human (and monkey) mothers hold their babies very close to their bodies. In primitive cultures, a mother keeps her baby close day and night. A baby born to one of the Pygmies of Zaire is in physical contact with someone at least 50 percent of the time, and is constantly being stroked or played with by other members of the tribe. A Kung! mother carries her baby in a
curass
, a sling that holds it upright at her side so that it can nurse, play with her bead necklaces, or interact with others. Kung! infants are in touch with others about 90 percent of the time, whereas our culture believes in exiling babies to cribs, baby carriages, or travel seats, keeping them at arm’s length and out of the way.