Living at a distance: the losses of living remotely. From an interview with evolutionary psychologist Robert Dunbar:

Robert Dunbar. “… [C]ontact – social cohesion – is crucial for the human being. We are primates, and the apes spend hours a day in grooming practice to release endorphins, opiates which are much more powerful than any external opiates pain killers. We love to be hugged and touched but in a very delicate way and only in specific parts of the bodies: this kind of action can produce the release of endorphins and oxytocin as well. However, there are other ways, in current times when a handshake is not allowed, to establish social cohesion with the others: laughter, smiles, jokes, sense of humour and sharing interests although it is a complicated era.

Maria Giulia Marini. Do you think that there could be psychological damages because of social isolation, before and now? 

RD. Not in the long run. The human being is remarkably resilient: look at what’s happened during the Spanish flu, which lasted three years (1918-1920), or the Black Death in the XIV century and other plagues in the history. If it is a short time of lockdown, such as up to six months, we are very keen to cope. We have to consider the humankind historically since these episodes of zoonosis always occurred in the past centuries and we are somehow physiologically prepared for these emergencies. Now that the lockdown is almost over, we will be a little scared to go outside, to a restaurant for the first time, but at the second we will be more confident, and at the third, we will be back to our normal behaviour….

MGM. Distance learning, telemedicine and smart working are the most recurrent words of this period and are thought to be magic solutions here to stay.

RD. Digital networking was already there before the COVID. Personally, my contacts are all over the world, and there is nothing new for me to be on Zoom: this happens because as an academic, it’s part of my duty, doing knowledge sharing across the world. However, this is only one aspect of my job: interaction with students is also very important, and one thing is to build a class together being there with the body, another is to be far away. Two different outcomes, we should stop pretending that it is the same….

But going back to smart working, I think that face to face working is needed: the team are faster when they are in presence, the interactions are continuous; it allows better performance, better quality, not only based on an empathetic process….

We have to consider that when we talk about a patient, we have to take into account vulnerability. In this field, unless for proved safety reason, I would discourage to replace visits at the doctor’s site with a remote visit. The relationship is intrinsic in the therapy, and especially for older people, it is difficult that they can build this kind of involvement in a distance setting. It depends on the type of visit…. 

Face to face is essential, especially in times of fragility. Patients go to the doctors also to be listened to. This is already a great act of caring.

For other posts on narrative medicine, see here.