I'm really glad I found this bit of info. It might be good to put this in the docs somewhere accessible.
I'm still a complete n00b with Couchbase stuff, but I'm working in a similar problem space where it doesn't always make sense to sync an attachment, but it does always make sense to sync the metadata about the attachment.
This also gives way to the idea of lazy loading without actually syncing -- for example, if you were building an iPhoto replacement with TouchDB, you wouldn't necessarily want all of your photos from the past 5 years on one device since it might take up all of the storage you have on your phone, but you would still want to see thumbnails, or know that there are photos exist but are missing from the particular device. And, as mentioned above, if you've taken photos that another client should acknowledge the existence of, but that haven't been uploaded because you've set the app to not upload over cellular data networks.
Unless it's realistic that that sort of functionality will get added (or that it will be accepted as a contribution), it sounds like TouchDB might not be the right thing for my particular use case. :(