There are a variety of reports that have suggested that when patients encounter nature or visual images of nature that they experience less stress, anxiety, and pain. According to Ulrich and Gilpin, the impact of visual art on healing is tied to evolutionary theory, which suggests that the process of evolution in the natural world has hardwired humans to find certain kinds of nature scenes calming and restorative within the healthcare environment.[1] These authors demonstrated via a literature review that Nature depicted in art through various media has the same beneficial outcomes for viewers as does being in nature itself.[1] Patients recovering from surgery who were exposed to pictures of Nature with water experienced less postoperative anxiety.[2] In contrast, patients exposed to abstract pictures had higher anxiety than patients without any picture at all.[3] This suggests nature or landscape images may be most appropriate. Breast cancer patients reported reduced anxiety, fatigue, and distress during chemotherapy when exposed to screens displaying underwater scenes.[4]Various other reports suggest that perception of pain and anxiety can be reduced and perception of quality of care can be improved by viewing nature scenes.5,  6,  7,  8Certainly the well-regarded book by Jon Kabbat-Zinn, Wherever You Go, There You Are, suggests meditations while focusing on assorted natural images such as mountains and lakes promote mindfulness with the goal of stress reduction.[9]Hospitals are beginning to incorporate gardens in their architectural plans, and windows that allow natural light as well as images of nature. A growing body of evidence suggests that humans are programmed not just to enjoy a pleasant view of nature, but to actually derive benefit from it, much like a drug, to relax and refresh after a stressful experience. Simply viewing a garden or another natural vista can quickly reduce blood pressure and pulse rate and can even increase brain activity that controls mood-lifting feelings.[10]Ulrich and Gilpin have suggested guidelines for appropriate nature art content in health care that include familiar settings, waterscapes with calm water, landscapes with open foreground, trees with broad canopies and verdant vegetation, positive cultural artifacts (barns and older houses), and healthy plants and fresh flowers with open foregrounds.[1] Further research is needed to determine visual preferences among ages, ethnicity, race, and gender.As cancer physicians, we are able to witness miracles in healing and coping with physical and emotional illness. I believe that God provides us with daily occurrences of beauty in the natural world and that nature can have a powerful healing influence on all of us. There are daily miracles in the natural world: the continuous changing of seasons, the precious appearance of a flower on a rocky outcropping, the burst of color in the sky at dawn or dusk, the reflections of the sky, the leaves, and the grasses in a pool of water or rushing stream. When I am outdoors, time stands still and I am able to lose myself while watching and enjoying the abundance of nature. I am drawn to the light at the beginning and end of the day as well as the light from the stars at night. I enjoy the way light reflects in water or can illuminate a blade of grass. From Anne Frank’s diary:The best remedy for those who are afraid, lonely or unhappy is to go outside, somewhere where they can be quite alone with the heavens, nature and God. Because only then does one feel that all is as it should be and that God wishes to see people happy, amidst the simple beauty of nature. As longs as this exists, and it certainly always will, I know that then there will always be comfort for every sorrow, whatever the circumstances may be. And I firmly believe that nature brings solace in all troubles.[11]My avocation has become photographing the natural world and I have been honored to provide photographs for several areas in our hospital, including the radiation examination rooms. “Look deep into nature, and then you will understand everything better,” Albert Einstein observed. My goal as I contemplate the world with camera in hand is to portray the magic and beauty of nature in my photographs. Figure 1, Figure 2, Figure 3, Figure 4, Figure 5, Figure 6 represent images I have taken in the mountains of North Carolina. I hope that these moments can endure so that they can be enjoyed and bring as much peace and calmness to the viewer as they do to the photographer.

References

Ulrich RS Gilpin L Healing arts: Nutrition for the soul.in: Frampton SB Gilpin L Charmel PA Putting patients first: Designing and practicing patient-centered care.  John Wiley & Sons, San Francisco, CA2003: 117-146View in ArticleGoogle ScholarUlrich RS Simons RF Losito BD et al.Stress recovery during exposure to natural and urban environments.J Environ Psychol. 1991; 11: 201-230View in ArticleScopus (2471)CrossrefGoogle ScholarUlrich R Lunden O Eltinge J Effects of exposure to nature and abstract pictures on patients recovering from open heart surgery.Psychophysiol. 1993; S1: 7View in ArticleGoogle ScholarSchneider SM Ellis M Coombs WT Shonkwiler EL Folsom LC Virtual reality intervention for older women with breast cancer.Cyberpsychol Behav. 2003; 6: 301-307View in ArticleScopus (78)PubMedCrossrefGoogle ScholarDiette GB Lechtzin N Haponik E Devrotes A Rubin HR Distraction therapy with nature sights and sounds reduces pain during flexible bronchoscopy: A complementary approach to routine analgesia.CHEST. 2003; 123: 941-948View in ArticleScopus (270)PubMedAbstractFull TextFull Text PDFGoogle ScholarTse MM Ng JK Chung JW Wong TK The effect of visual stimuli on pain threshold and tolerance.J Clin Nurs. 2002; 11: 462-469View in ArticleScopus (54)PubMedCrossrefGoogle ScholarNanda U Elsen S Zadeh R Own D Effect of visual art on patient anxiety and agitation in a mental health facility and implications for the business case.J Psychiatr Ment Health Nurs. 2011; 18: 386-393View in ArticleScopus (45)PubMedCrossrefGoogle ScholarPati D Nanda U Influence of positive distractions on children in two clinic waiting areas.HERD. 2011; 4: 124-140View in ArticleScopus (35)PubMedCrossrefGoogle ScholarKabat-Zinn J Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life.Hyperion, New York1994View in ArticleGoogle ScholarWaldholz M Flower power: How gardens improve your mental health.Wall Street Journal. 2003; View in ArticleGoogle ScholarFrank A The Diary of a Young Girl.Doubleday and Company, New York1952View in ArticleGoogle Scholar

Article Info

Publication History

Published online: April 13, 2017Accepted: April 11, 2017Received in revised form: April 8, 2017Received: April 5, 2017

Identification

DOI: https://doi.org/10.1016/j.prro.2017.04.007

Copyright

© 2017 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.