Hug it Out
In this book, the instances of human contact are even rarer than sightings of Nicki Minaj fully clothed. The tendency to avoid contact is a combination of the stereotypical male tendency to shy away from affection and the fact that Dominick is so busy giving his entire life to Thomas that he forgets that he needs support, too.
When someone does touch Dominick, it's like that scene in American Beauty when Mena Suvari asks Kevin Spacey how he's doing—it kind of stuns him. The first time it's really noticeable is when Joy holds Dominick: "[Joy] kept holding me. Held on tighter, as a matter off act. Held on for over a minute" (7.118). Not that he really cares about Joy, but she does her best to show him affection, and instead of getting caught up in it, Dominick notices each second ticking by.
Later, Dr. Patel touches Dominick: "She reached across and covered my hand with her own small butterscotch-colored hand. Squeezed it. Relaxed the pressure. Squeezed again. The gesture was so unexpected, it disarmed me. Shut me up for once. 'Squeeze back,' she said. And I did" (15.47). The fact that he squeezes back, instead of just passively taking it, is a big deal—it's a moment in which he attempts to bridge the space between himself and other people, even if only because he's told to.
However, the biggest moment of contact is when Ray reaches out to Dominick: "Ray's big, rough hand—hardened by work, by war—reached across the table. Hovered above my shoulder for a second or two and then clamped on. Squeezed. As if we were father and son after all" (40.265). This moment marks their reconciliation, and Dominick's realization that Ray doesn't need to be his father by blood in order to be someone he can see as a dad.
In a book swimming with isolation, the moments of touch are really important. We can use them to get a sense of where Dominick is in his trajectory of healing (if that's how you want to think of his journey), and also to better understand how he feels about other characters. Joy's hug he tolerates, he follows Dr. Patel's orders to participate, and with Ray, he realizes that perhaps there's a bit of love between them after all.