Intersections: Art and Health
by Jessie Lumb
It’s early on a Friday morning in the Arts in Health office at Finders Medical Centre. A nurse rings from upstairs to ask if there is anyone available to come and see a patient who had been admitted the day before.
“He really loves woodworking”, she explains. “And he misses being able to do it.” But for obvious reasons such an activity isn’t possible in a public hospital.
I am about to head out on the wards for the day with the art trolley – a Sidchrome tool chest on wheels filled with all the art and craft supplies we can fit. As an Artist in Residence my job is to provide diversional therapy through the use of art activities to promote patient wellbeing. Depending on what day of the week it is, it might be a poet or musician that takes the call, but today it is me, and I say I’ll come up first thing.
Within a few minutes I find myself at the bedside of an elderly man. I introduce myself, and we chat for a bit. His speech is slow, his body stooped, but he’s bright and cheerful despite his circumstances. He tells me that at home he makes a jigsaw puzzle each day as a way to control the shaking in his hands.
One of the biggest considerations of the role is finding an art form suitable for the individual, something of interest to them that can also be adapted to what they are capable of doing. Felting and knitting are popular, as are painting and drawing, but relief printing - using tools to carve an image into a piece of rubber - is the closest thing I can offer to what this patient loves to do so I pull out the materials and start to explain the process. His eyes light up as he tells me he did this many years ago at school and asks for a pencil to get started.
‘To a fine bunch of helpers’ he writes without hesitation, in beautifully straight handwriting that fits perfectly on the block. I smile at his choice of words. Together we decide on the best tool for the job that will allow for a thin crisp line to match his text. He begins to carve, slowly, carefully, moving as fast as his hands will allow.
We talk throughout. I learn about his family and the work he used to do. I tell him about my job, and growing up with lots of sisters. I discover he loves to sing, that this isn’t his first time in hospital and that he wants to make cards to say thanks to all the top-notch staff that take care of him.
Part of a broader health team, Arts in Health sits alongside medical and allied health departments to provide a holistic level of care to patients in the hospital. An emerging field, it aims to humanise the healthcare experience, by using creative processes to retain a sense of individuality in a space where ones personhood is easily lost.
The body of evidence for such an intersection is growing. The British Medical Association reports that including arts and humanities in healthcare environments can bring about improvements in clinical outcomes; reductions in drug consumption; shortened length of a hospital stay; better doctor-patient relationships; and an improvement in mental health (1).
Physiologically, the multi-sensory aspect of arts engagement encourages brain activity in a number of regions, including the hippocampus, the area particularly associated with long-term memory (2, 3, 4). A number of improvements to physical function have also been shown to occur, in both people affected by strokes, spinal cord injury and brain trauma, as well those with chronic conditions such as Parkinson’s disease and multiple sclerosis (5, 6, 7, 8). Psychologically, the arts have been shown to reduce stress and anxiety, conditions associated with being in hospital and which have a demonstrated link with illness (9). It can help to regulate emotions by allowing an outlet for expression and provide avenues for acceptance of various emotional states (10). Socially, participating in the arts has been shown to foster a connection with others, battling isolation and loneliness, which in turn, helps to improve the overall wellbeing and physical health of an individual (11).
Just as importantly, engaging in the arts relieves boredom and distracts from the hospital routine, illness and pain.
“It’s wrong,” he says suddenly and I’m confused as to why. I double check the spelling and try to reassure him it’s correct but then it dawns on me. The design needs to be backwards and it isn’t. We laugh at having made such a simple mistake; both of us have done this before and should know better. He turns the block over and starts again.
‘To a magnificent crowd’ he writes instead. This time I help him with the words. He starts to carve again, slowly, carefully.
He pulls a handkerchief from his pocket to wipe his nose and then brushes the little pieces of rubber into a pile. He shuffles to the bathroom. The physio arrives and we stop so he can go for a walk.
“Not far” they reassure me. “Just to the nurse’s station and back. We won’t be long.”
I sit patiently through all of this and wait. Interruptions from staff, volunteers or family members are common, and usually take priority. If privacy is required I’ll step outside, but often I’m asked by the patient to stay and will continue the project quietly in the background or encourage the visitors to have a go too. Sometimes, like today, it’s a matter of putting things on hold for a bit.
When he is ready we look at his carving. It’s not perfect. He’s had trouble following the lines and some of the letters are wider than they should be. I don’t think it matters - it’s the doing that’s important, not the outcomes - but he disagrees, and tries to correct them as best he can.
I spread black ink onto a piece of acrylic and he takes the roller from my hand, remembering what to do. We fold coloured paper in half, lay it on the surface of the block and together rub the back in circular motions, my fingers following his to ensure enough pressure is applied to transfer the design. He peels it off in a moment of truth. It’s a little abstract but the message is there. We repeat the process on red, green, yellow and blue.
By now it is mid-afternoon and I realise I’ve been with him all day. Such a long interaction is rare. Time with a patient usually ranges from a short conversation to an hour, depending on the activity, but occasionally there is the need to stay longer and this was one of those times. He’s tired and tells me he has had enough so I pack up to leave.
He thanks me as I go - for giving him my time, for the conversation, for providing him with a distraction from the hospital, purpose for his day, and an activity for his hands. He is clearly exhausted from the concentration it has taken but assures me it has been a worthwhile way to spend his time.
In a few simple lines, he has summed up the benefits of programs such as this. Ultimately Arts in Health aims to create positive and nurturing experiences for patients and carers at a time when they are at their most vulnerable. In practice this isn’t for public display, happening instead in the wards and corridors of the hospital, a private experience between artist or performer and patient.
“You should write greeting cards” I smile in return, moved by the language he has used.
His grin could not have been any wider.
British Medical Association. The psychological and social needs of patients, London: British Medical Association. 2011
Thaut, MH. Neural basis of Rhythic timing Networks in the Human Brain. Ann N Y Acad Sci. 2003 Nov
Levitin DJ, Tirovolas A K. Current Advances in the Cognitive Neuroscience of Music. Ann N Y Acad Sci, 2009 March
Koelsch S. Towards a neural basis of music-evoked emotions. Trends Cogn Sci. 2010 March
Hayden R, Clair AA, Johnson G, Otto D. The effect of rhythmic auditory stimulation (RAS) on physical therapy outcomes for patients in gait training following stoke: a feasibility study. Int J Neurosci. 2009 Nov
Hurt CP, Rice RR, McIntosh GC, Thaut MH. Rhythmic Auditory Stimulation in Gait Training for Patients with Traumatic Brain Injury. J Music Ther 1998 Dec
Nomebela C, Hughts LE, Owen AM, Grahn JA. Into the groove: Can rhythm influence Parkinson’s disease? Neurosci Biobehav Rev. 2013 Dec
Conklyn D, Stough D, Novak E, Paczak S, Chemaili K, Bethoux F. A Home-Based Walking Program UsingRhythmic Auditory Stimulation Improves Gait Performance in Patients With Multiple Sclerosis: A Pilot Study. Neurorehabil Neural Repaire. 2010 Nov
Boehm K, Cramer H, Staroszynski T, Ostermann T. Arts Therapies for Anxiety, Depression, and Quality of Life in Breast Cancer Patients: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2014 Feb
Hillman J. Emotion: A Comprehensive Phenomenology of Theories and Their Meaning for Therapy. Evanston Illinois, Northwestern University Press; 1960
Shankar A, McMunn A, Banks J, Steptoe A. Loneliness, social isolation and behavioural and biological health indicators in older adults. Health Psycol. 2011