4 weeks gone by

Basically the idea that a good “leader� takes care of his/her “followers� still exists- for example in the military, in families, and of course, in “traditional� doctor-patient relationships. But in many places, that concept has gone completely out of the window- I’m thinking academic work environment, for example (see references to “pimping� in previous blogs). So while I agree that every physician needs to find the place where they personally are comfortable on the scale of directive vs. non-directive, I found it very reassuring that there is a concept that it’s ok to lead others, as long as you keep your end of the bargain- loyalty works both ways.

I think this may be especially interesting for women. Culturally, women leaders are often perceived in a negative way (as being “bossy�, rather than “assertive�). Since women generally also like to avoid things that antagonize those around them, that often leads to women not leading, even though they may be suited for it. So it’s just a nice thought that this concept exists for us, and it will benefit everyone, leaders and followers. I LOVE win-win situations...

On the last day, when we were trying to lead the horses over the “scary� blanket, I had to think about one of my patients again. He had been with us for a long time and gone through a long and excruciating treatment plan to successfully reject his cancer. At the end, he was completely sick of anything related to healthcare. At his request, we would enter his room only after taking off our white coats. When he finally got to go home, he didn’t go in for his scheduled follow-up, a “simple� blood-draw. As a result, a complication wasn’t discovered in time, and he died of it. After all the pain, and after having beaten his cancer, he still died of something that could have easily been corrected-

While ultimately, one has to respect every person’s informed decisions, even if it kills them, I was wondering whether he might still be alive if someone had taken the pain to accommodate his “irrationality�, and sent out a mobile nurse to him?
Which drives home another point of this class: always pay attention to your patients, and to what they don’t tell you. It may not kill you if you don’t, as a horse might. But it might kill them.

Overall, I am still astonished at how much I learned. My initial motivation for the class was just to hang around horses. It was amazing to see how well an animal can model a relationship between humans. We constantly project and transfer on a horse- my emotional reaction to a “noncompliant� horse may actually be not that much different from my emotional reaction to a noncompliant patient. It’s one thing to be taught about the dangers of projection in a lecture and another thing to be “caught in the act�! Guess which one you remember �

Lastly, I’d like to give a big hand to my fellow students, and to Bev! You’ve made this class fun, and a real growth experience. Thanks!