Ceiling-to-floor glass separates patients at the Samaritan Lebanon Community Hospital in Oregon from an 11,250 square-foot Japanese garden.© Samaritan Lebanon Community Hospital
"The patients were assigned essentially randomly to rooms that were identical except for window view: one member of each pair overlooked a small stand of deciduous trees, the other had a view of a brown brick wall," Ulrich writes. "Patients with the natural window view had shorter postoperative hospital stays, had few negative comments in nurses" notes, and tended to have lower scores for minor post-surgical complications such as persistent headache or nausea requiring medication. Moreover, the wall-view patients required many more injections of potent painkillers, whereas the tree-view patients more frequently received weal oral analgesics such as acetaminophen."
Hospitals still need to bring nature into the clinical setting. But there are a few trailblazing institutions as well as people like Becky Pape, CEO of Samaritan Lebanon Community Hospital in Oregon, who have become believers.
Indeed, only a curving bank of ceiling-to-floor glass separates patients undergoing chemotherapy at Samaritan Lebanon’s Emenhiser Center from a 11,250 square-foot Japanese garden. Designed by an award-winning father-and-son team, Hoichi and Koichi Kurisu of Kurisu International, the garden boasts three gentle waterfalls and mature black pines.
"We now know that exposure to nature is not just a nice thing—it’s essential," says Pape. "We"ll never build anything the way we did it before when it was all about technology. I’ve been completely converted. Before the garden, I would have bought a CT scanner or the equivalent with a large sum of money, but now I think we have to marry the technology with an improved environment for patients and staff."
Samaritan Lebanon patient Alice Koch couldn’t agree more. "You can lose yourself in the garden instead of thinking about the unfortunate things that have happened to you in the hospital," she says. "I get the most restful, positive feelings watching water tumbling down from the rocks and fish in the pools and the changing seasons."
Koch and Pape are not isolated voices. In the years since Ulrich’s seminal research, medical studies have confirmed what we instinctively know: providing access to the natural world can have measurable benefits. Specifically, healing environments with pleasant and interesting views of the outside world have been shown to promote faster recovery and shortened hospital stays, increased treatment effectiveness and decreased pain, and increased patient and staff satisfaction.
"The therapeutic value of a quiet meditative environment for individuals affected by a serious illness like cancer is widely recognized," says Dr. Bruce Chabner, clinical director of the Cancer Center at Massachusetts General Hospital. There the Howard Ulfelder, MD Healing Garden on the eighth floor of the hospital has an enclosed pavilion from which patients, visitors, and staff can view the 6,300 square-foot garden year round. "Our healing garden is an important complement to the excellent clinical care we provide."
Anjali Joseph, director of research at the nonprofit Center for Health Design, notes that "more and more hospital designs are incorporating nature into their plans, especially courtyard gardens."
Joseph says she is a passionate supporter of the movement to blend nature into clinical settings. "It’s very important to consider the patient as a human being, and I feel that people who are ill are highly susceptible to impacts from their environments," she says. "So anything designers can do to incorporate nature and bring natural light into facilities can be highly beneficial."
Hoichi Kurisu echoes Joseph’s philosophy. "After graduating from college in Tokyo, I joined my father in California where he was doing landscape design. To me, the first time in the U.S., I was amazed at the wealth—such a materialistic life. At the same time, though, it seemed the people were not happy, so I thought I could do something with my profession. Making gardens [for] people [to] spend just a little bit of time in each day, just 10 minutes noticing the flowers or the koi pond."
"Most of the patients I think come with anxiety and stress and loneliness," Kuirsu adds. "But in nature, you discover the huge boulder next to a calm pool, and you feel you are not alone and start to open your heart. It’s not right away like an aspirin, but it’s actually the beginning of healing."
Allowing nature to work as a restorative is something the folks at the Virginia Thurston Healing Garden in Harvard, Massachusetts are dedicated to as well. "To me it’s the sense of connection with something larger than yourself," says Elizabeth Tyson-Smith, executive director. "The garden gives you hope back because it’s a place where sunlight glitters and the leaves and plants grow. Everywhere you can find a free gift in nature if you look."
Clearly Florence Nightingale who in the mid-19th century observed that natural lighting was second only to fresh air in healing, wouldn’t find it radical. Neither, for that matter, would Vincent Van Gogh. Within days of admitting himself to the asylum in Saint Rémy-de-Provence in 1889, he set his easel up in the cloistered garden to paint his famous "Iris."JEAN JOHNSON is a freelance writer in Portland, Oregon.