Light Touch in the Operating Room

When Steve Raichelson, 58, of Annapolis, voiced anxiety last year about his upcoming quadruple bypass surgery, his cardiologist made an unusual suggestion: Have the operation at George Washington University Hospital and sign up for a session or two of reiki therapy there first.

Raichelson's cardiologist was not suggesting that reiki -- a form of alternative medicine that uses light touching -- would cure his heart. Instead, she knew that GWU Hospital's clinical director of cardiology, Joel Rosenberg, was collaborating with the hospital's Center for Integrative Medicine (CIM), on a six-month pilot reiki program. Patients about to undergo cardiac catheterization, in which a thin tube is threaded through a vein and up to the heart for a final diagnostic test prior to surgery, were invited to first have a session of the Japanese energy therapy to see if it lessened their anxiety.

Luann Jacobs prepares a patient for surgery at George Washington University Hospital. (By Robert A. Reeder -- The Washington Post)

Of the 428 patients approached, 266 accepted the offer. The program ran from December 2003 through June 2004.

An hour before his catheterization, Raichelson lay down on a table fully clothed but shoeless and let "reiki master" Luann Jacobs gently touch him as soothing music played. There was no pressure or muscle manipulation -- just a light laying on of hands.

"It helped me go through the procedure and relieved the pre-procedure stress," said Raichelson. "I'd do it again in a heartbeat, pardon the pun." His successful bypass surgery took place the next day.

CIM director John Pan said alternative therapies aren't necessarily an odd match with mainstream medicine. To treat a patient, he said, technical expertise is not enough. "We are realizing we need to pay attention to the patient, to the patient's emotional response." A relaxed patient, he said, is an easier patient to treat.

But hospital staff needed persuading.

A major hurdle "was getting physicians to be proactive in recommending it," said Rosenberg, who developed the pilot program in collaboration with Pan. "Many don't buy into this type of care. What we're involved in here is a cultural change. . . . We're trying to help health care providers appreciate the value of this. If patients have a better experience, the institution does better."

Did the experiment produce evidence that reiki helped patients? Not enough to be conclusive. The study did not include a comparison group, and only 36 of the 266 patients who underwent reiki were interviewed after catheterization. While a report on the pilot program noted some apparent, self-reported benefits, such as increased confidence and reduced anxiety, the paper stated that the patient questionnaires "did not elicit any clear findings."

But Does It Work?

GWU Hospital is not alone in its interest in reiki. A number of respected medical institutions including the Cleveland Clinic, the University of Michigan Health System and the Albert Einstein Healthcare Network in Philadelphia, are conducting clinical studies of reiki. Researchers at the University of Michigan Integrative Medicine program (UMIM) have just completed a study of reiki's effectiveness in reducing pain and increasing the ability to exercise among diabetic patients at risk for heart disease. The research was funded by the National Center for Complementary and Alternative Medicine (NCCAM), part of the National Institutes of Health. UMIM director and cardiologist Steve Bolling said journal rules bar him from discussing the study's findings prior to publication, which is scheduled for this fall. But he predicted that reiki will catch on in more hospitals.

"Many patients are looking for a kinder, gentler medicine," Bolling said. "[They are] certainly more open-minded than us white coats. People want this."

But that doesn't mean it works. According to a 2004 NCCAM review of reiki and similar light-touch modalities, there is "impressive anecdotal evidence [of benefit] but none has been proven scientifically to be effective."

Part of the problem is that there are no national standards or licensing for reiki practitioners, who may be judged ready to practice after only several hours of training. Becoming a reiki master requires an additional one to two years and is undertaken in order to be qualified to teach reiki to others.

"Standardization?" asked Bolling. "I wouldn't know where to start. If you've got four reiki [practitioners in a study], how do you know they are equal?"

Another complicating factor is the difficulty of determining whether a patient's response is attributable to reiki or just to personal attention: "If you are nervous and here for cardiac catheterization, no one will argue that [having] someone standing by your bed is bad," said Bolling. "People call it the grandmother effect. No matter who you are, your grandmother makes you feel better when she's around. . . . But it's hard to parse out the different effects of someone just standing there and a reiki person."

Researchers are approaching the problem in different ways.

In one NCCAM-funded study that has recently begun recruiting prostate cancer patients at the Cleveland Clinic, some participants will receive two reiki sessions a week for four weeks from reiki practitioners "trained to perform in the same way," said study leader Eric Klein, professor of surgery and chief of urologic oncology at the clinic. Meanwhile, a control group will receive an equal number of sham reiki sessions. A third group will get no reiki at all. The study will investigate reiki's ability to relieve anxiety while also measuring any impact it may have on the biology of tumors in patients with newly diagnosed prostate cancer.

"It's an honest attempt to evaluate reiki scientifically," said Klein. "My expectation is that those who get reiki will be more relaxed. The outside hope is that it will modify the biology of tumors." But, Klein continued, "that's 'out there.' "

Gala True, an NCCAM-funded researcher at Albert Einstein Healthcare Network's Center for Urban Health in Philadelphia, is investigating the use of reiki in reducing anxiety and depression while increasing quality of life among those with HIV and AIDS. In her study, patients are divided into two groups. Both continue to receive their standard medication, while one group also receives reiki. "There is no sham reiki [in this study]," said True. True acknowledges the difficulties of designing a trial that can satisfactorily measure reiki's effect.

"It's an interesting problem with [complementary and alternative] therapies," she said. "When you find a method for control, someone will disagree with it."

But like Bolling, she had no trouble recruiting patients. "We basically had a waiting list of HIV patients who wanted reiki. . . . It's been much harder to recruit for other studies." ·

Matt McMillen is a Washington area freelance writer.