Nature Photographs Brighten Cancer Treatment Areas

ATLANTA—Gazing up at a canopy of red fall foliage or a placid blue lake, the cancer patient is able to relax and momentarily forget the large radiation machine looming over her. She remains still and calm for her radiation treatment, and leaves the facility in good spirits. This is the goal of “visual therapy,” the use of nature photography throughout treatment centers but especially in high-stress areas such as radiation oncology.

The people behind this new style of interior architecture for medical centers are Joey and Janet Fischer, of the Art Research Institute (ARI), Atlanta, Ga. They are responsible for installations of large nature photographs in more than 2,000 hospitals and medical institutions around the world.

“For the last 5 years, we have focused on cancer centers,” Mr. Fischer said in an interview with Oncology News International, “and they now make up about 80% to 90% of our work.”

Mr. Fischer, a nature photography, and his wife Janet, a health care interior designer, stress that the environment in which treatment is delivered is crucial to a patient’s sense of well-being. Bringing nature into health care facilities, Mr. Fischer said, helps patients relax and better cope with the anxiety and stress of an illness or surgery.

Although the Fischers generally work with architects and designers directly, their approach has begun to attract support from hospital administrators and physicians. Physicians, he said, are increasingly aware that a patient-friendly environment not only contributes to the healing process but also makes an excellent marketing tool to the public.

Mr. Fischer believes his photographic murals of gardens and landscapes may be more appropriate than traditional works of art because nature is a universally appealing subject, not subject to individual artistic tastes. In addition to producing large prints for hanging on walls, Mr. Fischer uses his large nature transparencies in other innovative ways:

• To cover large fluorescent light grids in ceilings above radiation therapy machines, thus providing a bright backlit image for patients to focus on during treatment (see Figure 1).
• To wrap interior walls in bright uplifting images (see Figure 2).
• To provide backlit “interior windows” for subterranean and inner core environments where windows to the outdoors are not possible.
• To provide, via CD-ROM, a soothing alternative to the usual TV fare in waiting rooms.

Mr. Fischer’s inspiration came some 22 years ago when his father suffered a heart attack, and he noted the total lack of visual stimulation in the ICU. “He ended up counting the holes in the ceiling. He had nothing to occupy his visual sense,” he said.

Now, he and his wife work as a team using nature images to transform hospitals, with their long corridors and sometimes scary equipment, into a more serene and welcoming environment. “We’re a package,” Mr. Fischer said of his partnership with his wife. “We come into a facility, do a walkthrough to assess the places in need of imagery, and present a proposal.”

Janet Fischer uses her interior design skills to select images individually for specific areas, based on the needs of patients and the area’s overall design and color scheme and lighting. In some cases, Mr. Fischer will take photographs of the local area’s environment—bluebonnet fields for a Texas hospital or lake scenes for Michigan’s lake district—to create a body of work specifically for a facility. Otherwise, the images are selected from ARI’s extensive library.

Mr. Fischer said that the major manufacturers of radiation equipment routinely recommend the visual therapy concept to facilities that purchase their equipment. “My hope is that in the near future, nature imagery will be provided right along with the equipment package as an integral component of a healing environment,” he said.

He believes that including the artwork up front when the equipment is installed “allows both the manufacturer and the facility to make a philosophical statement about their commitment to providing quality patient care and to providing a more pleasant, less stressful working environment for their staff.”

In 1990, Mr. Fischer created his first “WindowStill,” a backlit nature transparency that uses computer-controlled light changes to simulate the 24-hour cycle of light and dark. The installation is used to help inpatients in ICUs or other windowless areas keep their circadian rhythms in sync with the outside world.

Mr. Fischer also offers a less expensive noncomputerized version of the “interior window,” trademarked “Indow,” which is designed primarily for cancer centers. This installation brings the ambiance of natural light and the spatial dimensions and look of a window into underground windowless environments.

The Indow consists of one of Mr. Fischer’s nature transparencies backlit in a window treatment. The light can be dimmed manually if a different mood is desired. “These simulated windows provide a view to the outdoors, helping to reduce the claustrophobic effect of being underground,” he said.

Mr. Fischer’s latest venture is, in essence, a “serenity channel” for the medical center’s cable TV system, which allows viewers to avoid the stress of regular daytime talk shows. Called Palette Cable, the system stores 700 original nature images on CD-ROM and broadcasts these images onto television receivers throughout the facility. Proprietary software allows each image to remain on screen for 20 seconds before morphing into the next, all to a classical music accompaniment.

Patients can view this stress-reducing anthology of images while awaiting treatment. “We know that in cancer centers, patients’ anxiety levels rise in the first 5 to 7 minutes after they come in for a treatment,” Mr. Fischer said. “The usual blaring TV probably doesn’t display what an ill person needs to see, or a well person for that matter.” By viewing nature images instead of Oprah or Montel Williams, he believes, patients can “redirect negative thoughts.”

Mr. Fischer’s pioneering work in visual therapy was recently recognized with a Computerworld Smithsonian Award for “visionary use of information technology to produce positive social, economic, and educational change.” The winner’s work becomes a part of the Smithsonian Institution’s Permanent Research Collection. The nomination in the medicine category came from George Fisher, chairman of Eastman Kodak Company.