In this work, we propose a novel metaphor to interact with volumetric anatomical images, e.g., magnetic resonance imaging or computed tomography scans. Beyond simple visual inspection, we empower users to reach the visible anatomical elements directly with their hands, and then move and deform them through natural gestures, while respecting the mechanical behavior of the underlying anatomy. This interaction metaphor relies on novel technical methods that address three major challenges: selection of anatomical elements in volumetric images, mapping of 2D manipulation gestures to 3D transformations, and real-time deformation of the volumetric images. All components of the interaction metaphor have been designed to capture the user’s intent in an intuitive manner, solving the mapping from the 2D touchscreen to the visible elements of the 3D volume. As a result, users have the ability to interact with medical volume images much like they would do with physical anatomy, directly with their hands.