1. Craman, Anne Marie MSN, RN, PMHCNS-BC


A psychiatric nurse bears witness to an aging veteran's hidden possibilities.


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"Let's go for a ride," I said to Joe as he lay expressionless on his bed, covered in blankets and staring at the ceiling. The room was stuffy with hot, stale air. No bigger than a walk-in closet, the space held the lifetime possessions, many of them scattered on the bed, floor, and windowsill, of a 75-year-old veteran residing in an assisted living facility. Joe appeared frail and bored in the silence of the room.

Figure. Illustration... - Click to enlarge in new window Illustration by Janet Hamlin.

Raising his head, he looked at me inquisitively, but with a furrowed brow. "Alright," he said flatly, after some thought. "I have nothing else to do."


I am a nurse case manager in an intensive mental health case management program at a Veterans Administration hospital. Our program promotes recovery-oriented services that focus on helping veterans with serious mental illnesses reclaim wellness, hope, self-determination, and a meaningful life. Despite many challenges, including self-doubt and societal stigma, these veterans have many hidden treasures and aspirations. Sometimes uncommon opportunities can lead to wonderful accomplishments.


That day, after a bit of shared humor about the promise of the smell of sweet hay and earthy manure, Joe agreed to go for "just a visit" to a therapeutic equestrian barn that was the home of the Tuesday Freedom Riders (TFRs). The TFRs are veterans who participate in mounted and unmounted lessons and work toward individual and team goals. Joe's stated goal of "staying out of the psychiatric ward" had long been met. Despite his physical frailty, I sensed a smoldering fire that needed a spark.


At the barn, Joe's face lit up as he was awakened by the sights, sounds, and smells of horses. The instructor grasped his hand warmly as he smiled broadly with blue eyes locked onto hers. That day, he peppered her with questions. "Do horses sleep on their feet? How can you measure a horse with your hands? How do you know a horse is in pain? Do horses go outdoors when there is snow and ice?"


One of my biggest lessons has been to not underestimate the restorative power of the horses and the unconditional support that comes from the community at the barn. Over weeks and months, Joe learned the art and skill of communicating with, handling, grooming, and leading his favorite horse, Lucia. It's no small accomplishment to be up close and personal with a 1,500-pound Percheron cross. I began to hear him say, "I like going to the barn. It's something different. It's not the same old thing," and "I tell the residents what I'm doing with the horses and they ask me questions." Then we began to hear, "My dream is to ride Lucia."


I admit that I wasn't sure if it would happen, or should happen. There were naysayers as to the wisdom of riding, especially for a fragile person. But Joe had a medical clearance to ride, and wouldn't his gain be worth his risk? Why not stretch our imaginations and join in Joe's vision of himself, in defiance of doubts that he was too old or too sick? Hadn't he shown bravery in the jungles of Vietnam as a medic?


I heard a change in his tone of voice with every challenge accomplished and skill mastered, saw newfound confidence in his abilities and determination. He exclaimed aloud thoughts like, "I'm taking it in and liking it," and I began to imagine all of us on the horse of our dreams.


Finally, the day came when Joe would take his first and, as we would later learn, only ride on his favorite horse Lucia. Instructor, volunteers, fellow veterans, and I bore witness as Joe climbed the steps to the mounting platform. He was assisted into the saddle, and with side walkers and instructor in rhythm, entered the riding ring.


The sun shone brilliantly against the blue summer sky with billowy clouds. Joe and Lady Lucia made a handsome pair. Seated on a western saddle on a striking white horse, he sat tall and firmly commanded "walk on" and "whoa." Before dismounting, and with a broad smile, he complimented his horse and gave the thumbs-up victory sign. In our group wrap-up afterward, Joe shared how "precious it was to ride into the sunset with Lucia." His joy brought us to tears.


The lessons broke for the summer. In the autumn, we learned that Joe had passed away in his sleep. The flag was lowered to half-staff at the barn in tribute to our fearless Freedom Rider. We still remember Joe's joy and gratitude as he proclaimed, "She's so big, and I am so little to be riding her. But I accepted help and rode on. I reached my dream."