Calming Touch in Operating Room : Medicine: Margaret Pickford, volunteer hand-holder, has seen 1,200 people through cataract surgery. The doctor says she facilitates relaxation.

Walk into Dr. Stephen Turner’s operating room and you’ll find the usual inventory--table, patient, masked assistants and high-tech machines blinking and whirring in a surgical symphony.

But amid the well-orchestrated routine there’s a decidedly low-tech note, a grandmotherly woman sitting next to the operating table, holding the patient’s hand in a comforting grasp.

Meet Margaret Pickford, volunteer hand-holder and proud provider of something no sophisticated equipment can supply--the human touch.

“I think this is the most exciting kind of a volunteer job,” said the 83-year-old Pickford, who began her career as a medical assistant at the age of 10, holding a basin for her country doctor father on house calls.

For Turner, having Pickford in the operating room is a way to relax his elderly cataract patients, who remain conscious during the operation although they feel nothing. Staying awake means quicker recovery and less risk, but it also means patients have to lie very still in what can be frightening surroundings, he said.

“They’re really sort of shut off from the outside. By having the hand-holder they have some connection,” he said. “She really calms them down quite a bit.”

Patients also can warn the doctor of any incipient coughs or sneezes--disaster to the delicate business of eye surgery--with a squeeze of the hand.

In four years of working as a volunteer hand-holder, Pickford has developed a finely honed routine that starts with a cheery preoperative chat.

Inside the operation room, she takes up her station, holding the patient’s hand under a surgical cover as work begins. Turner looks through a microscope for the meticulous task of tunneling into the eye to vacuum out the cataract, a diseased lens that has become opaque, causing partial or total blindness.

To the naked eye, it appears that Turner’s hands are barely moving, but a video camera beaming a magnified picture to a closed-circuit television reveals myriad short, sharp movements as the cataract is broken up and sucked out.

The 21-minute operation ends with a new lens folded over and slipped into the tiny opening and then unfolded on top of the eye. The microscopic opening generally does not require stitches.

Turner and his staff aren’t the only ones watching their handiwork. Family members may view the videotaped operation on a waiting room monitor and often take the tape home as a memento.

The operation ends with a few soothing words to the patient, a final squeeze from Pickford and then it’s on to soothe the jitters of the next patient.

The concept of promoting human contact is a good one, said Dr. Walter J. Stark, an ophthalmology professor at Johns Hopkins University in Baltimore. Although Stark doesn’t have official hand-holders, he does encourage making contact with the patient from the handshake of the first consultation to reassuring pats from nurses and anesthesiologists.

“The anesthesiologists in particular are in agreement that if you sit with the patient . . . and you reassure them, you can get by with a lot less anesthesia,” he said.

“The patient realizes they’re being treated as an individual and somebody cares about them.”

As a veteran hand-holder of more than 1,200 surgeries, Pickford has experienced everything from the occasional delay because of mechanical failure to being surprised to find a friend on the operating table.

But the operation that sticks out most clearly is that of a 103-year-old man who was having cataracts removed from both eyes and took a lot of calming down.

The patient found the operation to be a true eye-opener.

“The nurses (at his nursing home) said they had been leading him around (before the operation) and now he was chasing them,” she said.