Therapeutic horsepower during coronavirus: The surgeon seeking solace in his horse *H&H Plus*

We riders are luckier than most in this pandemic. We are likely to live in the more rural areas of the UK. We may have space around us and our horses nearby. While the rest of the country is told to lock down, we have an excuse to be out in the fields. We have a duty of care to our animals. We must see them fed and watered and sometimes even ridden to keep them healthy. Like dog owners, who must exercise their canines, this gives us a sense of purpose at a time when the world is full of miserable stories and economic distress. This virus as far as we know is not bold enough to take on equines. Our fields are not full of animals breathing their last breaths as the patients are in my hospital in north-west London, where the epicentre of the British pandemic seemed to start. Luckily for me, when I got the job in Harrow nearly 30 years ago, my wife insisted in her forceful way that she was “not going to live inside the M25 under any circumstances”. Thus we have a good measure of breathing space around us in our rural idyll and it is here where we keep our horses. [subscriber-content]These past few weeks since our poor, stricken Prime Minister ordered us to remain at home, my routine has changed. When I am not in the hospital I am training my slightly bewildered Irish Draught hunter, Galway, in the manège. The two of us go slowly and sedately round in circles. Some have argued that we should not be riding at all, but the chance of injury while walking over poles to a hunting-mad man like me seems about as remote as the Government suddenly having enough coronavirus testing kits on offer. Perhaps it makes Galway better behaved with his field-mates and that might mean less chance of injury and so reduce the likelihood of calling out a vet. Deep psychological scars Indeed, my ritual that has developed by necessity is as therapeutic for me as for my horse. The horrors of what my colleagues, who are in the front line with the Covid-19 patients, have seen at the hospital are beginning to bring deep psychological scars. We have 400 Covid-19 patients occupying half the beds in the hospital. The other half are only partly filled because all our elective surgical patients have been postponed. We crack on with the surgical emergencies – peritonitis and obstruction and so on – but find a proportion have Covid-19 changes in their lungs in addition and do not do as well as expected. We wonder when our semi-urgent surgical cases will be done at all and we are having great difficulty fitting in the cancer sufferers. We fear at any moment that the next wave of Covid-19 patients will take up the remaining empty beds in the hospital. Two of my colleagues have died of coronavirus. One, aged 55, went home to Germany to self-isolate and died alone in his flat preventing his daughters from visiting him less they too got infected. A close consultant friend, who operated with me just a few weeks ago, is fighting for his life on a ventilator in a nearby chest hospital where we have sent our overflow patients. This is the stuff of Shakespearean tragedy and there seems no final curtain yet in sight. There is not much joy either in the nearly empty corridors of my hospital as relatives are discouraged to come in to see their loved ones. There is even not much staff gossip to chew over anymore either, for when the front-line staff are not locked in the Covid-19 wards, they are encouraged to be away from the hospital when not on duty as much as possible. Only the old Stalinist hospital canteen is open now with tables three metres apart. Costa Coffee, M&S and WHSmith have all closed, so it is not even possible to buy a paper let alone a mango smoothie. None of us know when or how this will end. We talk of herd immunity almost as if we too were horses. We hope beyond hope that the virus will mutate to something more benign any time soon. We dream that we have each had the infection subclinically already and thus are now immune. Certainly neither doctors like me, nor the country as a whole, has ever seen anything like this since the Great Plague. Pasteurella pestis, the flea-loving bacteria that caused the Black Death in the 14th and 17th centuries, spared only half the population and heralded the end of the feudal system. Each wave of the plague took 18 months to abate. Let us hope this plague is just a fraction as cruel. If we experience anything near that devastation there will be only one thing with which we horse tribe can console ourselves. Wait for a warm evening. Grab a bunch of carrots, tramp out into the field and embrace your horse. They may not understand why you are there, but their smell, their warmth and their innate dignity will heal much of your pain. It may not cure all the ills around you, but I guarantee your soul will be the better for it. Ref Horse & Hound; 23 April 2020 [/subscriber-content]