How horsemanship techniques can help doctors improve their art
Horses are exquisitely sensitive to how we present ourselves. They pick up on every nuance of body language. They can even sense our emotions, especially when what we say is not what we mean or feel. As mirrors to our intents and behaviors, they will always let us know how we appear to them. In learning to notice the horse’s responses, medical students are trained to become more aware of how patients respond, even when patients are too polite to raise objections in so many words. Does the patient wince at the cold stethoscope? Does she withdraw if the doctor is violating her personal and cultural boundaries? Does she feel ignored or disrespected? Horses are not afraid to tell us all of these things by laying back their ears or simply walking away.
One of the most popular sessions is the physical exam of the horse taught by our equine veterinarian. Students learn to approach the horse slowly and gently, constantly checking in with ears, tail, and other body parts to see how the horse responds to being examined. We ask the students, if patients could lay back their ears, what would they tell us?
Brannaman, who derived his principles from the giants of Natural Horsemanship of the past, bases his work with horses and people on a few main principles:
Break the task down into smaller tasks that the horse can understand. Use pressure and release to teach each part of each task. Pressure is the ask. Release is the reward for attempting the task. Reward the smallest try, by release of pressure, even if the head or foot moves half an inch in the desired direction. Release is going back to the last place the horse felt comfortable. Relationship is the most important aspect of horsemanship. It is not the equipment or technique, it is the quality of relationship, feeling and communication.In Medicine and Horsemanship, everything we ask of a horse is informed by those principles. A favorite exercises is an activity we do during Halloween week called “UNinformed Consent “. Students attempt to get the horses through obstacles that are scary to them but no-brainers to us—a flapping silvery space blanket, balloons, scarecrow, etc. The students have to be extremely patient and slowly build up trust. The horse’s fear and resistance is a metaphor for patients who have to undergo scary procedures—anything from a simple phlebotomy (blood draw) to someone with needle phobia to major surgery. We know we can’t get the horse through the scary thing all at once. If he even looks at it, we release the pressure and take him back where he felt comfortable. That way, we slowly gain his trust.
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