Wrap Up...Third and Fourth Classes & NCEFT

Last week we had a small class, but this did not detract from the great learning experience. We started out with Lucia who explained and demonstrated a physical exam of a horse. We thought this horse would be tempted to resist the exam but she was very cooperative. The most troublesome thing for the horse was all of the flies! Lucia explained that examining horses is different from examining humans because horses will let you know if they are uncomfortable with the exam and this signal may be life-threatening! The main teaching points that I got from Lucia were (1) Take your time to make sure the patient is comfortable with what you are doing and if he/she is not, then step back and go to where it is comfortable for them, and (2) Make sure that you, as a physician, are appropriately prepared for the exam/procedure and that you feel comfortable with what you are doing. For me, this second teaching point was important because there are many times when I don't properly prepare (ie: for a biopsy) and I believe this leads to inconsistencies. It also made me remember that I have to look at my patient for non-verbal cues as insight to how they are feeling/reacting to what I am doing. It was also a lesson in how to get something done when you have a resistant patient... We ended this class doing an exercise being one unit of 3 people playing roles of "the brain" or "an appendage." This was a communication and team-work exercise in putting on a bareback saddle onto a horse. My biggest take home message was that I am not comfortable taking the leadership role if I do not know what I am doing. We need to remember to ask for help in these situations.
The fourth and last class was a perfect way to end. We did an exercise called "informed consent." The exercise was to lead a horse over a shiny reflective surface that is otherwise scary for the horse. As humans we know that the surface was harmless but the horse does not know this, especially if this is new to them. Medical things and procedures that are apparent and second nature to us are not necessarily the same for our patients. This reminds me of a patient that I had who refused to take any oral medication for a serious illness. As physicians, these medications seem benign and it doesn't make sense to us that a person would refuse these "harmless" medications. We finally asked "Why?" and the answer was apparent. In the country where she was from, these medications were considered dangerous with a lot of side effects. The therapeutic riding session was heavenly. I enjoy taking time out for myself to relax - I just don't do it often enough. I enjoy being with the horses and I finally feel more comfortable with them. I would like to find a way to spend more time with these creatures who have so much to teach us, both about ourselves and about relationships and interactions with others.
And NCEFT, was an uplifting experience. I brought a co-worker who was just amazed at the possibilites for those with neuromuscular difficulties. I commend those who do these treatments and I find it amazing that we have hippotherapy and therapeutic riding as options for our patients and loved ones.
Thank you to all of my classmates and especially to Beverly for this wonderful opportunity.