Healing calls for more than hospitals

Story by Trudy Duivenvoorden Mitic. Illustration by April Caverhill. July 2010

It’s time to return to patient-centred care that includes fresh air, sunlight, plants…life!

In this halcyon summer day the wind is tousling the treetops and the early tomatoes are beginning to swell on the vine. I wander around my little sanctuary and think of places that offer no such solace. I think of the Victoria General Hospital. My friend—I’ll call her Rose—has been living there since Christmas.

In the midst of her holiday preparations, Rose fell ill because of a malfunctioning medical implant. Four surgeries later she surfaced back to consciousness but was left with permanent damage to her short-term memory. Assessments were conducted, a rehabilitation routine was completed and then came the verdict: She would no longer be able to live at home.

Rose is a young senior who capably tended to her home, family, garden and community. She walked her dog everywhere. Last year she taught me how to can pears. If I asked, she could talk me through the process again but then she’d soon forget that we’d had that conversation. Such is the enigma of the mind, to have so much lucidity locked up in so much limitation.

Rose has been in hospital for over six months now, waiting for space in one of the Vancouver Island Health Authority’s special care residences. The conundrum here is that she must stay in the hospital to stay on the list, a dinosaur of a regulation that fills the hospital with people who don’t belong there, creates a shortage of beds for those who do, and increasingly sucks the dollars out of other government budgets.

But here’s the main reason I’m thinking of Rose today: The hospital really is no place to call Home. At the VG there’s no garden, no brightness, no normalcy and nothing to do. Every day Rose gets a little more despondent, a little more lethargic, a little more hopeless over the transience of it all. She is deteriorating and for her loved ones it’s a bitter pill to swallow, considering her setting.

Visitors—and thankfully there are several—can take her outdoors, but there are no paths for strolling, no garden for hope and reflection, and no covered area for sitting on a hot or rainy day. No, the best place to visit, reads the message coming down, is from the chair by the side of the bed.

It hasn’t always been this way. For centuries gardens helped heal the body and soul. They were integral to healthcare settings until the early 20th century, when rapid advances in medical science shifted the focus from patient-centred care to the hospital itself as the setting for new technology and treatment. (There’s nothing like an orderly row of patient-filled beds to boost the efficiency of staff and machines.) Patients were recast from self-healing humans to diseased entities who could not recover without nurses and doctors, says Mark Epstein, a Seattle-based landscape architect specializing in therapeutic landscape design.

Now we know better again, so therapeutic gardens are making a comeback at many Canadian hospitals. At their best they will include features that “represent life and health, such as trees, plants and flowers, and elements that arouse the senses, such as fragrances, the sounds of birds and water, and the feel of sunlight or a gentle breeze,” says Epstein. “These elements represent a marked contrast to most hospital interiors (and provide) a sense of distance or escape while allowing for reflection and restoration.”

The Jubilee Hospital has three such gardens that, along with a restored historic chapel, provide sanctuaries for patients and their families, staff and visitors.

The VG urgently needs to provide this too, especially a friendly outdoor space to counter all that rock and concrete. Everyone would benefit. For patients like Rose it could help to preserve mental acuity and therefore some control over her own fate. It could mean the difference between spiralling downward and picking up the threads in her eventual new home. For patients like Rose, a garden could mean the difference between living and existing.

Trudy Duivenvoorden Mitic is a writer, mother and Master Gardener. Her books include People in Transition and Ernie Coombs: Mr Dressup (both from Fitzhenry & Whiteside).