{"id":46659,"date":"2020-04-22T09:41:49","date_gmt":"2020-04-22T08:41:49","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=46659"},"modified":"2020-04-23T10:31:52","modified_gmt":"2020-04-23T09:31:52","slug":"elliott-martin-the-healing-garden-lost-to-corporate-healthcare","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2020\/04\/22\/elliott-martin-the-healing-garden-lost-to-corporate-healthcare\/","title":{"rendered":"The healing garden lost to corporate healthcare"},"content":{"rendered":"

Everybody needs beauty as well as bread, places to play in and pray in, where nature may heal and give strength to body and soul – <\/span>John Muir<\/span><\/em><\/p>\n

It has been three years since the demolition of the Prouty Garden at Boston Children\u2019s Hospital. The venerable, beloved garden is gone. In its place will soon be a <\/span>\u201c$1 billion-dollar state-of-the-art clinical building<\/span>.\u201d 1<\/sup><\/span><\/p>\n

There was an unspoken power here and the garden was a wellspring of strength. Knowing that others had traced these well-worn paths, had lingered under the shelter of the magnificent dawn redwood tree provided succor and courage, rekindled hope, reconfirmed faith.<\/span>2<\/sup><\/span><\/p>\n

Meticulously designed and heralded as a premiere therapeutic healing garden;3<\/sup>\u00a0the garden was a reflective place. This is a children\u2019s hospital, after all. Wonderful and terrible things happen\u00a0<\/span>here, and the garden was a real place of respite. Beyond the reach of chaos, of despair. A place to\u00a0<\/span>play, to walk. A place to think, to pray, to gather one\u2019s self. A place to grieve.<\/span><\/p>\n

\u201cIt has cradled so many distraught and worried parents who have left a little part of themselves\u00a0<\/span><\/i>behind to give strength to the newcomers. It is so much more than the sum of its parts. It is\u00a0<\/span><\/i>testament to all the families who have suffered and won or lost there.\u201d 4<\/sup> <\/span><\/i><\/p>\n

The Prouty Garden was the soul of the hospital. The town green. The public square. The place where people gathered, took deep breaths, and returned to face the day, rejuvenated. The place that helped wonderful people, doing incredibly difficult jobs, want to come to work.<\/span><\/p>\n

\u201cI feel like I am not in the hospital anymore when I am in the garden. It is so nonhospital;\u00a0<\/span><\/i>nothing in there is like the hospital; it feels so open, so bright and colorful\u2014the fresh air, the\u00a0<\/span><\/i>breezes\u2014it\u2019s great to get out of the sterile cave.\u201d <\/span><\/i>5<\/sup> <\/span>\u00a0<\/span><\/i><\/p>\n

Why is there no garden anymore?<\/p>\n

Hospital leadership cited the need for modernization and expansion to meet the growing demands for more intensive care facilities, and more advanced cardiac care and surgical facilities. As the process unfolded, plans solidified to create a state-of-the art destination facility, aimed primarily at wealthy families, nationally and internationally.6<\/sup> The most economical and efficient architectural plan, and the one ultimately chosen, sacrificed the Prouty Garden.<\/span><\/p>\n

The garden\u2019s threatened destruction sparked a struggle. Thousands of patients, families, staff, and community members rose up to defend the garden. Petitions were signed, stories documented, vigils held, local and national media coverage engaged. Benefactors funded the (unsuccessful) legal defence of the garden. Pre-eminent socio-biologist, Edward O. Wilson, considered the matter an environmental emergency, <\/span>\u201cWhat you plan (destroying the Garden) will put you (Boston Children\u2019s Hospital) on the wrong side of history.\u201d 7<\/sup> <\/span><\/p>\n

The response from the administration; \u201cWe looked at the cost-effectiveness, we looked at the time it would take, we looked at what it would bring us in terms of patient care. When we put it all on the grid, the building that we’re going to build (on the site of Prouty Garden) really fit the best.\u201d 8<\/sup><\/span><\/p>\n

Is this then the future of medicine? The wedding of real estate development and corporate health<\/span>care? Where the voices and priorities of patients, families, and dedicated staff are muffled?\u00a0<\/span><\/p>\n

In place of the garden will no doubt be a technological marvel that will serve patients and families. A \u201cnewly opened rooftop garden comprises a small patch of green space surrounded by hardscape, tables, and chairs, along with several statues salvaged from the Prouty Garden.\u201d 9<\/sup> <\/span><\/p>\n

A facade of a healing garden really, surrounded by a citywide view, raised beds, and glass walls. No natural shade or wildlife, precious little breeze. <\/span>It is no replacement for a real garden, an authentic healing space, serving all patients and their families, regardless of diagnosis, circumstances or ability to pay.<\/span><\/p>\n

The loss of the garden is especially distressing at a time when most urban areas are desperately seeking to reclaim green space, and mounting evidence substantiates the therapeutic value of gardens within hospital settings.10<\/sup> <\/span><\/p>\n

The Prouty Garden was established in the 1950\u2019s, before healthcare became an industry, when physicians frankly acknowledged the limits of their own abilities to cure and focused more on <\/span>healing<\/span><\/i> patients and their families. A healing garden thus stands in contrast to the corporatization of healthcare, although perfectly aligned with the core values of the healthcare professions.<\/span><\/p>\n

The loss of the Prouty Garden\u2014for over sixty years a paragon of therapeutic landscape design and cherished healing resource for every generation\u2014should be a jarring wakeup call to the irony of the current state of health care.<\/span><\/p>\n

Let us hope that the lessons of the Prouty Garden\u2014its immense healing value and its sad,\u00a0<\/span>contentious destruction\u2014will guide us and other institutions going forward.<\/span><\/p>\n

Elliott Martin<\/strong> is the Director of Medical Psychiatry at Newton-Wellesley Hospital in Newton, MA. He is also Clinical Assistant Professor of Psychiatry at Tufts University School of Medicine. He was previously a fellow at Boston Children\u2019s Hospital. <\/em><\/p>\n

Competing interests:<\/strong> none declared\u00a0<\/em><\/p>\n

Elaine Meyer<\/strong> is senior attending Psychologist at Boston Children\u2019s Hospital, Affiliated Faculty at the Center for Bioethics, and Associate Professor of Psychology at Harvard Medical School<\/em><\/p>\n

Competing interests:<\/strong> none declared\u00a0<\/em><\/p>\n

References:<\/strong><\/p>\n

    \n
  1. Boston Children\u2019s Hale Family Building<\/span><\/a><\/li>\n
  2. Meyer E.C., \u201cLittle sparrow: discovering the healing value of a garden sanctuary<\/a>\u201d, American Journal of Nursing 2019; 119(2): 72.<\/span><\/li>\n
  3. Cooper-Morris, C., Sachs, N., Therapeutic Landscapes: An Evidence-Based Approach to Designing Healing Gardens and Restorative Outdoor Spaces. Hoboken, NJ: John Wiley & Sons, 2014<\/span><\/li>\n
  4. Moore R., \u201cHealing Gardens for Children\u201d, in Healing Gardens: Therapeutic Benefits <\/span>and Design Recommendations, Marcus CC, Barnes M, eds. Hoboken, NJ: John Wiley & Sons, 1999, p. 353<\/li>\n
  5. Save Prouty, \u201cPreserve Prouty Garden<\/a>\u201d, Change.org Petition<\/span><\/li>\n
  6. Bartlett J., \u201cGroup opposing Boston Children\u2019s $1B expansion faults state oversight<\/a>\u201d, Boston Business Journal, 10 September 2018<\/span><\/li>\n
  7. Farragher T., \u201cDoctors say fight for the \u2018soul\u2019 of Children\u2019s Hospital isn\u2019t over<\/a>\u201d. The <\/span>Boston Globe, 18 Dec. 2015. Web 30 Apr. 2018<\/li>\n
  8. A garden is at heart of dispute over Boston Children’s expansion<\/a>, Becker’s Hospital Review<\/li>\n
  9. Description of the new rooftop garden at Boston Children\u2019s Hospital,<\/a> The Cultural Landscape Foundation<\/span><\/li>\n
  10. \u201cHospital gardens are making a comeback<\/a>\u201d, BMJ 2017; 359: j5627<\/span><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

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