Horse tales and other lessons learnt

My first NHS Non-Executive Director role was at Wrightington, Wigan and Leigh (WWL) NHS Foundation Trust. I was blessed with a great Chair and CEO and over the seven years that I worked there, I learned a great deal from both these wise and generous men. Unusually, they both became friends, as well as colleagues. I think some of the most important lessons I learned from my time with them were: to always remain curious, to always consider the impossible when looking at solutions to problems and the importance of being able to communicate with whosoever you met.

 

That was a while ago now, but I continue to benefit from their insight. Sadly, the CEO, Andrew Foster died in March last year. Like many folk, I still miss him. Even when he and I left WWL, we would periodically meet up, have a couple of beers, and put the world to rights. We would meet halfway between his and my house, at a pub situated on the banks of a river. During the summer, you could sit on the terrace and it was a lovely way to spend a couple of hours. These days, I still pass the pub on a regular basis and each time I do, those memories make me smile. 

I was reminded of Andrew twice last week. The first occasion was during interviews for our last Board position, Director of Corporate Assurance. The successful candidate also worked at WWL, and we were able to have a bit of a catch up as well. The second occasion followed my reading of the story of Peyo, a therapy horse who works in a palliative care centre in northern France. Amazingly, Peyo ‘tells’ his trainer, Hassen, which patient he wants to visit, by standing outside that patient’s particular door. The horse appears to have the ability to recognise when a person has a tumour or cancer and has a wonderful ability to ‘be with’ people and reduce their pain and anxiety, as they near their end of life.

 

After performing at shows, the 15-year old horse would often seek out the company of people and stay with them. Hassen began to suspect that Peyo had special powers, and after nearly four years of investigation, vets now believe his brain functions in a unique way. Now some readers might be forgiven for thinking that possibly my mind functions in a unique way in making a connection between Peyo the horse and Andrew Foster, the Chief Executive.

 

Once, while I was at WWL we had a 77-year old patient, who was receiving end-of-life care for cancer. She was called Sheila Marsh. Although Wigan is part of Greater Manchester, it is surrounded by some wonderful countryside. Sheila lived in this countryside and had kept show horses for many years. As Sheila neared the end of her life, she told the nurses looking after her that her dying wish would be to see her favourite show horse, Bronwen, one last time. Andrew, his Director of Nursing and the family agreed to try and make this happen.

 

As Sheila’s condition deteriorated, the family arranged for Bronwen to be brought to the hospital. Staff wheeled Sheila’s bed outside and Bronwen walked straight over and started nuzzling Sheila. It was a very moving moment captured on Andrew’s phone. It was a photo that went viral when he posted it on social media. There were lots of tears, but smiles too. Her family said the moment was truly wonderful and had brought comfort to their mum. Sheila was to die just a few hours later.

Across all types of health care, it can be hard sometimes to measure the real outcomes of the care provided to patients, service users, and carers. With Sheila, there was no cure for her cancer. However, I like to think that the care Andrew and his colleagues, and Sheila’s family provided to Sheila eased her passing.

Inevitably, we will all die. For some people, death will be sudden and unexpected. However, for many of us, there may well be time between when we know that we are facing a life-shortening condition and actually dying. It is during this time that planning for a good death is important. Many folk don’t like to talk about dying, and it can be a difficult thing for individuals and their families to get into. Equally, many health care professionals can find it difficult to talk with the people, who are facing the end of their life. 

However, trying to find out what really matters to a person dying is critical if their preferences, wishes, and beliefs are to be met with care. I believe that doing so is as important as is the physical assessment and planning of care to keep people pain free and best able to cope with other physical problems they might experience. As with many aspects of health care, good communication is what will ensure a person’s physical, emotional, and psychological needs are met in a person-centred way. 

The story of Bronwen illustrates to me what might be possible when those lessons of always remaining curious; considering the impossible when finding solutions to problems; and the importance of effective communication with others are foregrounded in the way we think about providing care for others. I thank all those who so generously and freely provided me with so many opportunities to learn.