After the triumphant creation of my seafaring jigsaw masterpiece, I returned to OT the next day to see what John had in store for me – or, more possibly, for him.
‘Good afternoon, Lady Tara.’ he bowed ‘How kind of you to grace us with your presence again.’
‘Yes, I thought so.’ I agreed as I rolled in. ‘What are we doing today?’
You will be pleased to know,’ he replied ‘that we will not be doing a jigsaw. We will never be doing a jigsaw again for the rest of eternity. Instead, I have decided to ask YOU what accomplishment you would like to target for your hand function by the time you leave hospital. Something that we can use to focus your hand therapy in a way that you are more, shall we say, engaged in.’
I thought for a few seconds. ‘Doing up a bridle’ I replied. That’s something that would be a challenge and I would find useful’
“Is this’ John asked ‘for when you need to ride across your estate?’
‘Of course’ I replied ‘It’s far too big to get across on foot. And sometimes one needs to trample down trespassing peasants and I’m not heavy enough.’
‘It will be the highlight of my therapy career to know that I have enabled, through my expertise and dedication, the trampling of wayward peasants such as myself under the steel-shod feet of your steed.’ he replied. ‘However, I find that the occupational therapy room is fresh out of available bridles and, would you believe, horses. Would you be able to supply either of the above?’
‘I can supply bridles with a range of bits and a small variety of equines to choose from.’ I responded. ‘However, I feel doubtful that I’m going to be able to get either of the horses into the hospital lift without security doing a lot of running around and shouting into walkie-talkies
‘What’ interjected Mary, the redoubtable, Scottish head of OT, ‘the hell are you two going on about now?’
I turned to her. ‘Do you think I could bring a horse into the gym next door?’
“No you bloody couldn’t’ said Mary, who was not one to mince her words. ‘We’ve had the occasional dog in there but no horses. For obvious reasons’.
‘Well this isn’t going to do at all.’ I responded. ‘Have you seen the size of my spaniel? I can’t ride THAT across country.’ I turned to John ‘What are we going to do now?’
‘Well, Lady Tara,’ he answered ‘I guess it means that you will have to put the bridle on me. I will build a horse’s head that I can wear and then you can put the bridle on that.’
‘Excellent’ I agreed. ‘I could even bring in a lunge line and whip and lunge you from my wheelchair in the gym.’
‘I have no idea what any of that even means’ replied John ‘but it sounds like we have a plan.’
Mary looked between the two of us and clearly concluded that we were joking. (Narrator: ‘This was a mistake.’)
Over the next few weeks John and I worked hard on my hand therapy. I had weights attached to my wrists and flexed them back and forth, I played random computer games requiring some basic (very basic) dexterity to operate the controls, I had my hands massaged and stretched every day, became a Connect 4 champion and worked out how to clear the peg solitaire board in about three minutes because I did it so often. I have to confess these were not life skills that I thought I would acquire in hospital but they can now be added to my CV; perhaps in the ‘overview section’. “Tara is a C6/7 tetraplegic with many Connect 4 victories under her belt and surprisingly fast commando crawling skills. She can be left for long periods on her own if supplied with peg solitaire.”
One day I came into the OT room having been reading about FES therapy. FES stands for Functional Electrical Stimulation and does exactly what it sounds like. You put electrodes on various muscle groups, run electricity through them to contract the muscle and off to relax it. In this fashion, paralysed muscles can be worked and built up again, especially when loaded with weight – for example pedalling a stationary bike. You would have thought that after the Das Kerplunking at the hands of my consultant I would have had enough of getting electricity run through me but, as ever, I was always eager to try anything that might aid recovery so I asked Mary why we didn’t have any FES kit in our unit. I then had a very NHS-typical conversation.
‘Oh we do’ she replied
‘We do??’ I queried
‘Oh yes’ she said, ‘we have a very good piece of kit to work the muscles in the forearm so as to open and flex out hands.’
‘But I’ve been coming for sessions in this room every day for months and I have never seen anyone using or been offered myself to use FES’
“Ah yes’ she replied. ‘Well it’s very expensive so we’ve been told not to advertise the fact we have it. We have to wait for patients to ask to use it.’
‘But how the hell are patients going to ask to use something they don’t even know you have??’
‘You just did’ she pointed out. I stared at her, feeling much like Alice dealing with the insanity of Wonderland. ‘To be clear, you are telling me that if I had not happened to read about FES kit and then come to ask about it, you would not have been allowed to mention the fact that you had some?’
‘That’s right’ said Mary
‘And now I, completely by chance, have unearthed the existence of this useful and relevant kit, am I allowed to use it?’
“Well that depends on you passing the assessment for it’
‘I’ve been having hand therapy in this room every day for FOUR MONTHS. How can you not know whether it can help me or not by now?’
Mary looked resigned. ‘I’m quite sure you could benefit’ she replied ‘but I have to put you through the official assessment for FES before we can use it on you. Those are the rules we’ve been given.’
I rested my head on the table in disbelief. ‘What happens in the official assessment?’ I asked in a muffled tone.
‘I use the FES on you’
‘You assess whether I can use the FES machine by using the FES machine on me?
I lifted my head up and then banged it down a few times.
‘All right’ I said ‘Sign me up’.
Some days later Mary asked me to meet her outside of my normal OT time in the unit’s canteen. I did so. She told me to follow her and set off down a maze of corridors I had never ventured down before and then into a small side room. In here, out of the sight of any other patient who might spot the top secret FES kit, she stuck a few electrodes on me and tried it out on both my forearms. The sensation, whilst not pleasant, was no more than an electrical tickle after the ministrations of Das Kerplunk machine but, to be fair, I suspect that being nailed to a live pylon in the rain would also be a mild tickle compared to that. Certainly I later met other patients who said they found FES too unpleasantly painful to use and, only recently, I was in physio using a different type and apparently was happily withstanding a setting of “20” on my hand when most people start screaming at “10”. Perhaps my central nervous system was entirely reset by my insane consultant. Either way, I’m delighted to report that I sailed through my assessment and added regular FES therapy to my hand OT.
As we worked on my hands, John and I continued to plot the grand finale to my hand therapy – namely, the day that I would triumphantly succeed in doing up a bridle around John wearing a horse’s head and demonstrate to the unit how to lunge someone. In preparation one day I made the mistake during OT of innocently googling ‘lungeing a person’ and came across a phenomenon known as ‘pony fetishism’. For those of you who claim to not know what this is, it’s when people dress up as ‘horses’ to be treated as such by ‘riders’. Strangely, these people appear never to have encountered a real horse because they, almost without exception, made all their horsey outfits out of PVC. Whilst this displays admirable ‘wipe-down’ practicality, it means they can’t move very freely, get rather hot and make squeaky noises when they trot – but maybe that’s all part of the allure. I showed the pictures to my fellow OT patients and John to much hilarity and helpful suggestions as to what John’s pony outfit would be.
Unfortunately, it turned out that the pony fetishists were the straw that broke the, er, horse’s back, as far as hospital management was concerned. When I finally turned up several weeks later clutching my bridle, lunge line and whip – all kindly brought into the hospital by my mother, obvs – ready to put John through his paces, my entrance was blocked by Mary. Behind her, on the table, sat a hollow cardboard horse’s head made by John to wear and beside it stood the man himself looking somewhat downcast. The news of our escapade (and the google search) had spread and the powers that be had decreed that I was NOT allowed to demean the office of NHS Occupational Therapy by taking one of its uniformed members, placing a cardboard horse’s head on him, tacking him up and then lungeing him in the hospital gym. Honestly. Some people.
Instead both John and I had to make do with just putting the bridle on the horse’s head sitting sadly on the table. You don’t need me to tell you that it just wasn’t the same.