Horse Sense
by Vasudeva Iyer, MD
Watching the majestic horses competing in the Kentucky Derby is one of the most thrilling sights that I crave to experience each year. I observed with great joy the parade and the positioning of the horses at the gate; most of them, except for a couple of rebels, appeared eager to run and cooperate for the post-positioning. While enjoying the scene and eagerly awaiting the ringing of the bell heralding the opening of the gates, my thoughts wandered on the topic of horse vs. medicine.
During my fellowship training at a medical school in the midsouth, I had the privilege to interact with an attending neurologist, who was born and brought up in Texas. He had the peculiar habit of admonishing the resident whose narrative of clinical history and differential diagnosis did not reach his expectations:“ Show some horse sense, my boy.” Having come from another country, I was unfamiliar with the term horse sense. I sought to figure out what he really meant by that expression; being in the“ pre-Google era” it was not an easy task. The librarian opined that my best source is Encyclopedia Britannica; the definition given by that esteemed source was“ the ability to make good judgements or decisions: common sense.” It appears that there is uncertainty about the earliest use of that term; often, credit is given to James Kirke Paulding, who apparently used the term in his novel Westward Ho! in 1832. Another source mentioned is the New York magazine, The Nation, which commented,“ The new phrase – born in the west, we believe, of‘ horse sense,’ which is applied to the intellectual ability of men who exceed others in practical wisdom.”
A decade later I moved to Louisville, which with the Bluegrass counties is the prime location for equestrian culture in the U. S.: where the thoroughbred sires enjoy far more luxuries than the lowly human. I had forgotten all about horse sense until a recent encounter with a delightful patient. Lately my medical practice( I daresay, a post-retirement hobby) consists mostly of performing electromyography, viewed by most patients as a painful and awful procedure. I have realized over years that distracting the patient by engaging in conversation is one of the tricks for making the experience less
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