If you’ve ever been to Florence, Italy, you may have seen l’Ospedale degli Innocenti, a striking Renaissance building. Over the years, the hospital has housed the work of many Florentine Renaissance masters and was one of the earliest instances of artistic decoration in a hospital setting.

Today, continuing the intertwining of healthcare and art, is The Foundation for Photo/Art in Hospitals. Founded in Florence by Elaine Poggi, the organization provides photographic images of nature to hospitals around the world. The artwork provides positive distractions for patients and visitors and transforms the stark interiors of rooms and public areas for staff as well.

Exposure to nature art benefits patients and serves multiple aspects of the person, an important principle in many forms of complementary medicine. Improvements found through research include enhancing the immune system and reducing stress, which accompanies grief and illness associated with hospital stays.

This unique idea came to Elaine Poggi when she returned home to the U.S. for her mother who was in treatment and hospitalized with Non-Hodgkins Lymphoma. The blank walls in the hospital room had an ill effect on her. As a visitor, she found it hard to sit for hours giving comfort to her mother without anything but white walls as her surroundings.

Starkness did nothing to alleviate her sadness or loneliness. The room and the feeling in it were improved when she brought in her own enlarged underwater photos and other scenes of Tuscany. She meant to brighten the room, and this also shifted the way people felt and interacted. Hospital staff took note and enjoyed the benefits too.  What Elaine did instinctively, researchers and practitioners are now studying further.

This area of inquiry began nearly two decades ago with a foundational study that was the spark for the advancement of this field. Titled “View Through a Window May Influence Recovery from Surgery” Roger S. Ulrich Science 1984, Vol. 224, 420-421, it received wide attention when it appeared in the important journal Science. Windows were deployed and took on a new and important role in hospital and patient care settings. Other kinds of greening followed suit.

Nature exposure through artwork, as in Poggi’s nature-themed photography, can open a kind of virtual window. Providing a lookout onto nature improves wellbeing. If one cannot go outside for an excursion they might be set down in a garden. Or, even if one can look out onto a view of a tended landscape or wild scene, natural images add to the “nature effect” and support healing.

There is in humans an affinity for nature. This is a reflection of the concept biophilia, a term coined in the book of the same name by author Edward O. Wilson. Wilson advanced the idea that human beings evolved in specific wild environments with other living things. Today, we respond to nature because our wiring still echoes similar urges. We find nature a comfort zone because of our species’ environmental past.

Another important work exploring the benefits of nature was San Diego journalist Richard Louv’s Last Child Left in the Woods. This book and a later work, The Nature Principle, have led many to embrace nature anew. Louv considers our present generation to be suffering from nature deficit disorder.

The Foundation for Photo/Art in Hospitals was involved in a recent Italian study that supported the use of nature imagery. The survey findings were organized into a hierarchy of rankings that revealed what types of imagery its subjects preferred. The subjects reported that the presence of specific artwork made them feel safer. Nature and landscape imagery were found at the top as most conducive to that feeling. Abstract art was at the bottom as least desired in this setting. When patients were given different types of artwork or none, they preferred natural landscapes first, followed next by scenes with animals. Only three percent of patients preferred blank walls.

Francesco di Costanzo, head of Oncology at Careggi Hospital in Florence, led the study in collaboration with Poggi whose images were used in the six-year research project “Beyond Tradtional Treatments: Establishing Art as Therapy” from 2004 – 2011. Careggi Hospital was the first recipient of Poggi’s donated gift of photographs.

The health effects of being surrounded by beauty and nature has become a leitmotif and a key finding of an emerging field called evidence-based design. Art, medical science, clinical work, and nature intermingle here. This interdisciplinary approach is already shaping changes to the look and feel of selected institutions around the world. It may yet transform many more institutions and facilities, bringing more life to spaces both inside and outside healthcare facilities.

Best practices are being cataloged and over time may evolve to more radical changes to the look and feel of hospital rooms. In the lives of patients this might mean they will experience hospitals as easier places to be. Those who wish to better understand the power and healing potential of art, natural scenery, natural light, and rooms with a view are taking part in ongoing efforts like the Careggi study in a field where art and healthcare intersect. Ultimately, this research can assist those who translate clinical findings into innovative hospital design and the foundation of complementary services as best practices.

But these makeovers are not merely cosmetic: they are classed as therapeutic because they support medical goals. Other studies in the field have shown that generally nature imagery can reduce stress markers, such as cortisol levels, can reduce the use of pain medication, shorten hospital stays and alleviate anxiety.

It was not research that sparked Elaine’s impulse to share her own photography. Since its beginnings in 2002 following the death of her mother the previous year, Poggi and many others who have come on board have placed more than 3,000 photographs in hospitals around the world. Poggi found that her work improved once it had a purpose. Other participating photographers have added photographs to the gallery catalog. They, like Poggi, donate their work and time.

The scenes take patients all across the globe, temporarily removing them from an uncomfortable present. Offering virtual windows, they bring those in hospital environments to landscapes they may have never seen, or to places that may spark memories of places they have been.

Patients, their families and the facilities’ administrators are grateful for the gifts. It gives them a positive distraction, and while it’s not likely most patients are aware of the science behind it, their wellbeing is improved. In some instances, these images accompany them on the last days of their life journey.

A scuba diving photographer, Poggi has captured underwater scenes and many other calming worlds. The gallery includes a wide array of imagery: beaches, animals, desert and wilderness, settings spanning the globe from the Red Sea, to the Maldive Islands.

Some institutions decide on their own which specific photographs they want. Sometimes Poggi is the one to do it. Whether it’s cherry blossoms in Japan or views of the Tuscan Hills, whatever the choices, an appreciation of nature is universal. It is something that unites all of us, crosses cultures and faiths.  Still, when the institutions themselves select the artwork, biases seem to follow subtly distinct taste patterns, sometimes showing a noticeable national or cultural flair.

Poggi and the ongoing narrative of her foundation offer a unique story of how grief can be transformed. Elaine Poggi lost her mother in 2001. Her mother’s death changed the course of her life. Through the sadness of her mother’s hospital ordeal and her bereavement came a healing gift to the wider global community.

Katherine Relf-Canas 2012