MAINSTREAMING ARTS IN MEDICINE
A TALE OF TWO CULTURES
This is a new Web site about the growing pains of a wonderful phenomena
called arts in medicine. With my apologies, being a new site it's a bit
wordy, and there are a few typos, which I will try to address in due
course. I hope you find it interesting and of value.-- Bob Allston, April,
Please contact me at firstname.lastname@example.org.
- Arts in medicine (AIM) is a new movement that is gaining popularity
around the world. As it is practiced at the University of Florida's Shands
Hospital and other hospitals it includes volunteers and staff that
interact at bedside with patients employing a broad spectrum of art forms
to effect healing. These include visual art, music, dance, story telling,
acting, among many others. It also goes by various other names including
arts in healthcare and arts in healing.
THE MIND-BODY CONNECTION
- The fundamental premise of arts in medicine is that art affects the
mind and the mind affects the body. (For this discussion we can view the
mind and body as one if we prefer.) Although some years ago there might
have been some question on the point, that all important issue is now
fortunately in the past. We could examine a number of different sources;
all of which leave no doubt that this premise is on very firm ground. For
instance, there is a 1998 dissertation on the subject. Although its main
focus is philosophy, Chapters 3-8 (among others) provide an excellent
overview of the modalities of the mind body connection: The Power of Thought to Heal:
An Ontology of Personal Faith.
THE ART-SCIENCE CONNECTION
- AIM is also inextricably involved with various scientific disciplines
in three fundamental ways:
- First is the issue of the nature and degree to which social sciences
such as psychology, sociology, anthropology and economics may be
effectively employed in supporting the delivery of arts in the bedside
environment setting. Consider for instance the complexity of how to
optimally employ anthropological findings in the delivery of bedside
music, art and dance or how to employ psychology to optimize the
effectiveness of bedside human relationships in general. Included here
are all of the so called "therapy" disciplines such as art therapy, music
therapy, dance therapy, recreational therapy, physical therapy,
occupational therapy, etc., all of which employ various of the social and
physical sciences to optimize their utility and effectiveness.
- Secondly, science is employed directly to determine the comparative
merit and effectiveness of various modalities of art healing. Thus if we
had a staff of ten people all of whom are proficient in various modalities
of art healing such as painting, meditating, praying, listening to music,
telling stories, etc., we need to employ them in a way that will optimize
their healing results. Its just the old economic equation-- making the
most of resources. Thus one designs clinical trials in much the same way
that the medical profession carries out clinical trials; for both AIM and
medical science are merely different modalities of healing-- pursuing the
same goals-- improving health and well being. There is also the
possibility of combining AIM and established medicine in a manner similar
to that employed in shaman rituals; wherein the subject drinks a herbal
remedy and is surrounded by an upbeat song and dance routine to give the
remedy a positive mind set and send off. Such routines were honed through
thousands of years of cultural evolution. Thus a modern counterpart to
this would be that after a serious operation, the patient might experience
various compatible forms of music, dance, art, prayer and companionship to
help her/him pull through. We don't have thousands of years to hone the
effectiveness of any such procedures so modern science must and can short
cut the time to perhaps a few years. I should say here that I'm not taking
any position that herbal remedies or shaman rituals are or aren't
effective, because I have no knowledge of the subject, only that they,
like any other modality out of human experience, are worthy of objective
- The third major way in which science comes into AIM is to help guide
and define its social/cultural place in society. Thus, how to appeal to
volunteers, how to gain dedicated students, how to set up courses, how to
manage projects, what trade or professional organizations will best
serve, contracting with host healthcare institutions, etc. Here, numerous
social sciences come into play-- psychology, sociology, education,
anthropology, marketing, economics, management, administration,
accounting, etc., etc.
A FLUID DYNAMIC WORLD
- Coming up with the right answers as to how to employ the best art and
the best science for healing in AIM is in no way optional if arts and
medicine as a discipline is going to survive over the longer term. For it
is a fluid dynamic competitive world for ideas and services out there; and
that profession or discipline that can deliver the best goods and ideas
will grow and survive at the expense of the discipline that can't. And
this is equally true whether we are talking about untrained unpaid
volunteers or highly educated highly paid professional people.
- Thus exposure and interfacing with all elements of this fluid dynamic
environment is essential for AIM's healthy growth and development. And of
particular note here, are the therapy professions. Do they have the edge
on AIM by incorporating various sciences in their knowledge base? Should
AIM pursue the same ones, different ones, or none at all? Should AIM pack
up in favor of proceeding with these established disciplines?
AIM DISCREDITING ITSELF
- I have attended many lectures over the past year on the subject of
what is variously termed alternative medicine, holistic medicine,
complementary medicine, etc. The most pervasive complaint that all the
speakers invariably voice is the perception that their form of healing is
unfairly not recognized and not sanctioned by mainstream medicine or the
mainstream public. (And of course if a modality of medical treatment is
sanctioned by mainstream medicine, it stands a good chance of being
accepted by the mainstream public as well.)
- One also gains the perception at these talks that it is mainstream
medicine that, due largely to self interest, refuses to recognize the
merits of alternative methodologies; a point which also appears to be
rather universally accepted by the audiences.
- The issue is of course of utmost importance; for if the modality of
healing is valuable and not getting recognized the public is the loser. On
the other hand if it is ineffective and the public employs it in
preference to more effective modalities then the public loses also.
- However, in the case of arts in healthcare as practiced in
Gainesville, rather than being established medicine, it is Arts in
Medicine itself that is most curiously characterizing itself as a modality
of healing that is outside of mainstream medicine; with mainstream
medicine actually providing much of the support and facilities for Arts in
Medicine to, in essence, discredit itself. A related problem is that the
same dynamics that are causing AIM to discredit itself are causing it to
progress and expand at a snails pace compared to what it could be
- And thus, as is the case with the other alternative approaches to
healthcare, future generations will find they have an impossible task in
changing this perception; very possibly blaming mainstream medicine as
- Of course, this analysis only applies to the Gainesville, Florida Arts
in Medicine organization, and I have no knowledge one way or the other as
to whether it applies to others. As well, I don't mean to suggest that
other holistic modalities of healing have or have not traveled down the
same road, for I have no knowledge about them one way or the other.
However I do offer it as an example to other Arts in Medicine/Healing
organizations, and possibly other holistic modalities of healing, should
they currently be going down the same road.
- The issue can best be understood in examining writings and statements
of the founders and lead people in the organization available on the Web.
The founders are John Graham-Pole, Shands pediatric oncologist and Mary
Lane, Shands nurse, pursuing her Ph.D in nursing with a minor in art at
the University of Florida.
- There is an article entitled Dr. Artist
on the Web, from a Gainesville newspaper, the Moon, quoting Dr.
- This article does not evince the interests and perspectives of a
medical researcher and it appears to be designed to appeal to people who
are critical of medical science or perhaps science in general. Although
this article is a few years old (1995), with a modest search, I haven't
come across any material that is more substantial or generally contradicts
it. There is an article by John Graham-Pole in the Shands
Hospital Arts In Medicine Web site.
- If we examine Web articles relating to the other founder, Ms. Mary
Lane, we find the same result, as with Dr. Graham-Pole, although of a
little different nature. Mary Lane is also the head of research for CAHRE,
the University's education and research arm of AIM. I'm consulting three
Web pages relating to her.
- Creative Healing
- First Ph.D
- About the Book:
- Basically, it appears she has undergone psychotherapy and found it
lacking whereas she attributes her recovery from depression to her art.
She does not characterize what AIM people do as therapy or therapeutic nor
does she apparently believe it is. For CAHRE's leading researcher, her
writing about her research also appears atypical, with an apparent
indifference to conventional research guidelines and controls. Her
language also appears to be designed not to appeal to either a mainstream
population or the scientific community, and it is clearly beyond the
bounds of customary academic reserve.
- To understand the issue a little further have a look atCommon
Questions About Science and "Alternative" Health Methods.
- It is also instructive see
Why Bogus Therapies Often Seem to Work .
- Also, compare, for instance, the writings of both of the founders to
those concerning Dr.
Elizabeth Targ, who gave some talks recently at the University of
Florida on her research into prayer that I attended. We find that in
contrast, this article evinces no reservations about science and the
language is characteristic of those involved in scientific research.
- The article notes that "most doctors want proof", and the character of
the article suggests she is committed to do what she can to give it to
- Indeed she obviously sees science as mainstream researchers see it; as
an ally and indispensable tool for establishing the effectiveness, or lack
of effectiveness, of whatever phenomenon she is studying. (Although I'm
not here taking any position on the character or validity of her research
since I'm not familiar with it outside of attending the talks).
- It may be worth mentioning that, from the standpoint of the philosophy
of science, if she establishes the scientific validity to prayer, she has
simply established it as a natural phenomena, that is, an element of
natural law, the same as any other such law. And follow up studies would
simply pursue and refine her findings in the same vein, as for instance
followed the discovery of penicillin.
- However the supernatural world is a different "system" and I don't see
that science would have anything to say, one way or the other, if one
wants to ascribe to prayer supernatural powers. This is an element, I
think, which could be beneficially incorporated in an ideological profile
of AIM as discussed below.
- The administrative head of the AIM program is Christina Mullen. She
has advised me that she would not hire anyone that was educated in any of
the therapy professions and that she thought AIM should not do research to
measure its effectiveness.
- In carving out this small arts enclave at Shands Hospital, one could
almost assume that John Graham-Pole and Mary Lane have had their scrapes
with various skeptics in the medical and related professions. Thus I
suspect they may be somewhat prone to treat anyone in the sciences they
don't know personally with a bit of circumspection.
- As well, there are of course mutual animosities and negative
stereotyping between people in the arts and people in the sciences in our
culture. Thus I suspect that a combination of an anti-science bias by the
founders playing on pre-existing cultural biases and perceptions has
produced a negative perception and wariness in those AIM staff who have
been in the organization the longest (five years or more). In other words,
if you are from the arts, with little or no science background, and the
founders of your organization are respected medically trained people who
are down on established medical science and psychology, it is asking a bit
much not to expect you to adopt a similar attitude.
- There are two such paid staff members that occupy the main leadership
roles in the organization, next to the two founders and the administrative
head, mentioned above.
- I remember having a conversation with one of them. In raising issues
addressed in my paper on exploring AIM's niche, she just completely
stonewalled me. She just very politely said that everything was taken care
of and there was really nothing to talk about.
- The other administrative head has always had a difficult time relating
to me also and it is all but impossible to engage her in a conversation on
anything although she is always, as is the person mentioned above, very
polite and they are both pleasant to work with.
- I should mention here, that as a general rule, I am omitting people's
names where there is no need to mention them. However of course where I
consult something about them on the Web, its not possible.
- The last I heard, there were about a dozen salaried people in Shands
AIM, most of them Artists in Residence, and most of them rather modestly
paid. The Artists in Residence each concentrate on developing their
particular art form and performing for patients or working with volunteers
and patients in their field.
- As for unpaid volunteers, there are many times this number although I
hesitate to state the exact figure. Most of the volunteers are UF
students, some of whom receive academic credits for volunteering.
- AIM of course must interface with many different people and
organizations. For instance, patients throughout the hospital need to know
about the organization and what it offers. There are about 700 doctors on
the Hospital staff as well as many nurses and other medical staff who
might like to be informed about AIM services and activities.
- For an organization of such a scope and size, one might project the
following minimum organizational/management structure. (There is no hard
and fast rule on something of this nature of course).
- There would be one knowledgeable person (staff or volunteer)
available in the hospital AIM office to answer inguiries by phone, email,
in person, or otherwise for a minimum of 20 hours a week, the same hours
each week. As it is, there is no such person.
- There would be a comprehensive weekly schedule of events posted in the
AIM office in the hospital and posted on the Web. As it is there is no
such schedule. For the most part, if you want to know what is going on you
have to know who is involved in that particular activity and go to
- AIM needs an "open door" policy. That is, if a volunteer or staff
person has a question/complaint/grievance, etc., there needs to be
established a clear line of management through which they are encouraged
to pursue the issue should they wish to. As it is, if a volunteer or staff
person has a suggestion/question/complaint/grievance, etc., as far as I
know, it is not established whether or not management or the founders want
such issues pursued, and if so what the line of appeal through management
- As a result, without such simple structures in place, the present
organization tends to be very self limiting in size and scope to the
interests of a small long established clique who know how to navigate the
organization regarding their interests.
- For example, when I play the piano in the hospital Atrium (the main
lobby of the hospital) I will often get into conversations with people
about the possibility of performing in the Atrium themselves; for many of
the medical and other students are accomplished musicians. However, I
can't refer them to the AIM office to discuss volunteering in more detail,
because there are no established hours. Nor can I refer them to any posted
schedule of events so they can get an overview of AIM's scope and
character, and thus how they might fit in. All students are on the Web and
thus having such a thing on the Web would not only be a great aid in
enlisting new student volunteers but it would also be an aid for assisting
and keeping existing student volunteers as well; for of course all
stuedents need to work their volunteer efforts around their busy class and
- Thus I think it is safe to say that with such simple structures in
place, AIM would tend to grow in participation, which would in turn bring
on the need for yet further more sophisticated management structure to
accomodate the growth. Thus there might be a need for more organized fund
raising, branching into say, nursing facilities or foster care facilities,
research into the effectiveness of AIM's modalities of healing, etc.
AIM STAFF MEMBER DON LUTZ
AIM staff member Don Lutz performs such
things as writing for various organizational purposes and coordinates
various projects and programs for Arts in Medicine.
- Until this year, the only scheduled forum for discussion at AIM has
been what are called rounds meetings. They are generally held each week on
Thursday at 9:30 AM. The meetings are ostensibly reserved for discussion
of stories about bedside patient-AIM member relationships although the
subject matter often deviates from that subject. I fit into this subject
category due to the fact that I have many discussions with patients while
sitting at the Atrium piano. The meetings are usually attended from
something like 8 to 12 people.
- Starting in 1999, we have had meetings scheduled once a month, called
business meetings. Its not clear to me just what topics are allowed in
this forum. But my experience is that the subject matter is tightly
- I don't know what transpired before I arrived a year ago, but as it
stands, the subject matter that may be brought up in any official meeting
or function is tightly controlled by the founders.
- For the past year that I have been around AIM, I have been the only
person, outside of John Graham-Pole or Mary Lane, with either a hard
science or a science research background, that has been actively involved
with Arts in Medicine that I am aware of.
- This is not a high figure, considering there are around 700 doctors
alone at Shands. Of course there are science students that volunteer, some
of whom earn credits, but I don't know of any that have become actively
involved with the organization, attending for instance, rounds meetings on
a regular basis. Thus, I am the organization's male "science nerd", in an
organization that is less than enthusiastic toward both males and science.
(Very little of my background is in medical science however.) Some of my
THE "T" WORD
- When I first volunteered with AIM, I was eating lunch with a group of
AIMers. I mentioned something to the effect that it is good that what we
were doing was therapeutic for the patients.
- To my total surprise, I got nothing but negative responses to this
suggestion. We were not in the least therapeutic and furthermore we had
nothing to do with therapy. Completely perplexed, I first assumed that
they were saying that we weren't supposed to be helping people, which of
course made no sense to me at all. Trying to understand, I suggested that
it was an English word that applied to what we were doing; but to no
avail. We were not doing "therapy" or being "therapeutic".
- Sometime later at a rounds meeting, I broached the subject and Nurse-
founder Mary Lane took the position that we shouldn't employ the word in
any way to what we were doing with patients. However, Dr. Graham-Pole took
the position that we could employ it.
- Somewhere along the line I picked up the information that Nurse Mary
Lane had had psychotherapy for depression but had turned to painting in
preference to it; which, as mentioned previously, I gather is a reason she
is down on the idea that AIM might be therapeutic.
- And it was only a short time ago that administrative head, Tina
Mullen, advised me that she would not hire anyone that had a background in
any of the therapy professions.
PROTECTING THE FAITH
- When I first started attending rounds meetings perhaps 10 months ago,
I remember putting my hand up to speak a number of times in a meeting when
Nurse Mary Lane was leading the discussion, and I wasn't recognized. I did
the same the next week with the same result. I attributed it to just the
fact that I was new and she hadn't gotten used to me being there. As time
went on I found myself being unrecognized to speak and cut short when I
did speak rather often.
- Discussing the issue with the other two men who attended more or less
regularly, there was a consensus that she was biased against men. Then,
not too long ago, after a rounds meeting, she conceded to one of them that
she thought the organization should be limited to women. She also said
that she thought that if we instituted meetings run along parliamentary
lines with elected officers, etc., it would lead to male domination of the
organization (a rather curious stand in that men are a very small
minority). I should say however, that when other people ran the meetings,
at least as long as the subject matter stayed within the bedside idiom,
there was little if any such bias evident regarding being recognized to
WHERE IS SCIENCE
- On two occasions, during rounds meetings, John Graham-Pole asked me to
stop talking. On one of them I was trying to explain some issues out of
the philosophy of science-- the value of the scientific method.
- During my year or so volunteering with AIM, the organization's
anti-science character sort of crept up on me over time. Slowly
recognizing this, and increasingly perplexed by it, I thought perhaps the
organization might have been implicitly following some eastern views on
the subject-- as one might think could be associated with perhaps
something like herbalism or acupuncture; things I knew nothing about.
- Since the East didn't follow the West's path of development of
science, I thought it was possible they might have developed an
independent method of determining the effectiveness of their modalities of
healing. Indeed the idea rather fascinated me. If so, was it a logical
equivalent of the West's logic/mathematics/natural law structure or more
fascinating yet was it entirely different? Did it meet the criteria of
Aristotelian logic (by perhaps some other name) or was it based on some
other logical structure?
- Prior to volunteering with AIM, I had never given the matter much
thought but I implicitly assumed that eastern modalities of healing
probably had followed some course of cultural evolution which of course
readily fits into conventional western scientific perspectives.
- This was one of the reasons I attended virtually all the talks on
alternative medicine that came along, including talks on herbal healing
and acupuncture. However I should say that without exception, all of the
speakers were implicitly employing Western views and methods; essentially
the same structure that mainstream medicine or any other western
scientific research employs to measure the effectiveness of their
modalities of healing. I was also pleased to find that no one in these
talks ever asked me to stop talking although I contributed to the group
- After realizing this, I thought I could make a contribution by
explaining the nature and importance of the scientific method to our
people. However I increasingly found I was up against the general
anti-science perspective of the organization-- AIM neither has nor wants
anything to do with science. Thus, the argument goes, of what use is
knowing the value of, or following, the scientific method, in proving the
effectiveness of AIM's modalities of healing? We are art-- NOT science.
- Thus being silenced by John Graham-Pole on the subject, on the grounds
I assume that the subject wasn't appropriate for Rounds meetings, was
merely another of my continuing and rather unpopular attempts to introduce
scientific perspectives into AIM in areas where there was a need for them.
Sometime later, as discussed in the section below entitled Webmaster for
Two Weeks, I wrote a paper addressing
- On the other occasion that John Graham-Pole silenced me, I was
starting to comment on a former volunteer's Web site and other Web
presence such as Noreen Renier:
Psychic Detective? who is a professional psychic detective. Through
one of the other volunteers, I had helped the psychic move from one house
to another, for which I was kindly paid. During the move I asked her if
she could use her psychic powers to relate some facts about me, which she
got wrong. Also, one of the other people who plays the Atrium piano had
done the Web site for her in exchange for some psychic readings and
according to him, she got that wrong also. I don't think I had mentioned
either of these psychic readings when John Graham-Pole cut me off.
- As I have mentioned, rounds meetings were the only forum that the
group had for discussion; ostensibly limited to discussing patient bedside
relationships, although this limitation was commonly broached. Thus
whether John Graham-Pole was cutting me off for this reason or because I
was getting into unwelcome ideological territory, I don't know. For, he
may have anticipated that I might make some "science nerd" negative
comment about the efficacy of psychic healing or psychic detective work.
In general it is not popular to criticize such things among many AIM
- However, whatever the reason, the incident poses the ideological
question of whether AIM has an obligation to its own people, the Hospital
or the Hospital's patients to know, understand, and follow the dictates of
the results of credible studies of unconventional modalities of healing
(including our own) should they come up in conversations with patients.
- I would argue that we should. Of course having a forum where the
nature of scientific studies and such modalities of healing (of which we
are one) could be openly discussed would be a first step in addressing the
WEB SITE FOR AIM
- I am the only active volunteer in AIM with experience creating Web
sites. Realizing that a Web presence was long overdue for AIM, and there
was practically no knowledge about the Web among our people, I wrote a
paper, Aim and the Web to explain what the
Web was all about and how we could employ it. I passed copies around and
placed a copy in a three ring binder on a shelf in the AIM office.
- Although students and others found it interesting, to my knowledge
none of the long time AIM people, including the founders or administrative
people, ever touched it except Don Lutz. Dr. Graham Pole merely said he
would read it sometime but as far as I know hasn't. Many months later, one
of the artists in residence who was interested in building a Web site of
her own read it; saying it was excellent.
A SOCIOLOGICAL PROFILE OF AIM
- After writing the paper on the Web, I felt I might be able to make a
contribution regarding the organizational and sociological aspects of AIM,
so I wrote a paper entitled Exploring Our Niche"
with a view to raising our consciousness in these areas. I think its
fair to say that the paper addresses many subjects, completely vital to
AIM's long term survival, but as far as I could see were getting little or
- However, here too, the exact same result transpired as with the Web
paper. Upon seeing it, John Graham-Pole merely said the paper was too long
and as far as I know, hasn't read it. At the time, there was a somewhat
active volunteer that was working on her Ph.D in anthropology who was
quite interested in it and the subjects raised. I showed it to several
students who were also interested. Again, Don Lutz read it. However, as
far as I know with the exception of one or two that are not in
administration, all of the long time AIM people including the founders and
administrative people have completely ignored it. Of course when founder
John Graham-Pole ignores something, others in the organization tend to
WEBMASTER FOR TWO WEEKS
- Subsequently, at a "business" meeting in January, '99, I was appointed
Web Master for CAHRE, the University's research and educational arm of
AIM, in a volunteer capacity. I was also going to work on the Shands AIM
site under AIM administrator, Tina Mullen, where I am currently (April,
1999) making a small contribution.
- Since Web surfers interested in AIM would tend to be interested in
alternative and holistic modalities of healing, I thought it might be a
good idea to write a paper explaining the nature of science so surfers
could understand why Shands was largely limited to scientifically
demonstrated healing modalities. I put this to Tina Mullen and the Shands
Webmaster who supported the idea. I then wrote the paper.
- Then, two weeks after I was appointed webmaster for CAHRE, and after I
had put a good deal of thought into the design and content, all as an
unpaid volunteer, I was taken off the job. I was told the University
preferred to appoint their own webmaster and needed some examples of my
work, in which case they might appoint me again.
- So I inquired whether I might talk to the only people I knew were
involved in any AIM or CAHRE research, a maxilo-oro-facial surgeon, and
was told not to do so.
- Although I knew one of the people on the project personally, I decided
pursuing the issue further was a dead end. I also thought my paper on the
philosophy of science might have been the cause, at least in part, of
taking me off of the CAHRE Web site, so I decided not to offer it for the
Shands Web site. After all, as a volunteer, I had already seen two
comprehensive papers in which I was trying to make a contribution as an
unpaid volunteer summarily brushed aside.
- It is worth noting that, regardless of the merit of the papers, this
is a defect in management. Either the founders or the administrative staff
in such an organization that is so heavily dependent upon volunteers
should see it as their job to review such things, with a view to guiding
and encouraging volunteers to make useful contributions.
- Between them, these papers cover a rather vast area that, for the most
part, isn't being addressed otherwise, out of which progressive founders
or good administrative management surely would have found something worth
pursuing or developing. In the final analysis, it is the organization's
clique-like, suspicious and isolationist behavior persevering over the
pursuit of social and economic integration and good management.
- Currently, we are having one meeting a month devoted to "business",
although I'm not quite sure what the scope of subjects that is allowable
is. (I haven't been to the meetings since January, 1999). I went to the
first such meeting and it was monitored very closely by John Graham-Pole.
Indeed, I had talked only perhaps a minute when he told me to stop
talking. And although John Graham-Pole is characteristically quite
charming and easy going, he can be rather sharp at such times.
NO FREE SPEECH
- The fact that we have no forum for open discussion of general issues
of interest to volunteers or others has several subtle effects. First, it
forces those who want to discuss something to approach those in authority
on the side. This promotes cliquishness since only those who have the ear
of those in authority would probably attempt to do so. Second, and more
importantly, it limits the entire framework of what is discussed or
addressed in the organization, to whatever the founders or those who are
running the meetings, want to be aired. And as I have discussed
previously, the limitations are quite severe.
- AIM has been around for nine years and on the face of it, it is
surprising that this modus operandi has lasted so long without the
founders resorting to general purpose meetings. I understand the rounds
meetings are copied after meetings that doctors have, to discuss their
patient's illnesses with their peers. However I would assume doctors have
numerous other forums in which to raise other issues, which AIM doesn't
- I think the resulting dynamics of it is that people who for various
reasons fit into these various constraints stay with the organization and
those who don't, find it uncomfortable or lacking in some way and move on.
I would suspect the ability to receive a modest income has something to do
with it; as is the case with the artists in residence. Thus it is probable
that only a very small number out of the total number of people exposed to
AIM stay with it. Indeed, one sees very few new faces at rounds meetings,
considering the popularity of the AIM concept as evidenced by the Patch
Adams movie, etc.
- I recently (March, 1999) attended a banquet where I and many others
received recognition for 300 hours of volunteer service at the Veterans
Administration Hospital which is across the street from Shands Hospital in
Gainesville, Florida. There is a tunnel connecting the two making it
unnecessary to go outside for the five minute walk from one to the
- I began volunteering about a year ago with the Recreation Therapy
section of the VA shortly before volunteering with AIM at Shands hospital.
There are four full time recreational therapists at the VA, all of which I
believe are graduates of the recreational therapy degree program at the
University of Florida. All of them have been in their positions for many
years and at least one has been there for over twenty years. I would guess
the University of Florida has offered recreational therapy degrees for
thirty or more years. Thus in contrast to AIM, recreational therapy is a
well established profession.
- Much of what is done in recreational therapy is the same as what is
done at AIM. They have, for instance, several closets with arts and craft
materials available for their patients during most business hours. They
have musicians come in to play for them each week, as does AIM. They have
theater and dance groups perform for them on occasion as does AIM.
- They do some things that AIM doesn't do such as hold bingo games with
prizes and snacks sponsored by various veteran support groups. They show
video movies. Usually once a week they go out to eat at a restaurant at no
cost to the patients.
- Although there are undoubtedly some things that AIM does that
recreational therapy doesn't do, I am somewhat lost to find that it is
very great once the substantial difference in terminology and perspectives
have been taken into account. There is a difference in patient populations
however; in that there are few or no children patients at the VA. Many
people prefer to work with children. For instance, AIM people dress up as
clowns to entertain them and paint their faces, which isn't done at the
VA. AIM also does some more esoteric things such as playback theater.
- As does AIM, recreation therapy has student volunteers, some of whom
get academic credit for volunteering. The rec. therapists and volunteers
work directly with the patients (many of whom have serious disabilities)
with painting, games, crafts, music listening, etc., as do AIM people.
- Given the similarity of function and the fact that they are only a
five minute walk apart, it is striking that there is almost no
communications between the two and there are almost no volunteers that
volunteer with both. I am partly to blame for this for I have periodically
offered to try to put something together (the idea of which has been
accepted in principle by both) for the past eight months or so, but I
haven't put the necessary time into it.
- However, I'm about the only person in AIM who has expressed an
interest in working with them. And, before I was around, I understand
there was little communications between them. This is in contrast to the
situation with Alachua General Hospital, a few miles away (and owned by
Shands) where AIM now has a very substantial presence. Whether or not the
recreational therapy people know, at this writing, that AIM discriminates
against their profession in refusing to hire their people, I don't
- I have never heard anyone in recreation therapy voice any ennui with
scientific writing or science otherwise and recreation therapy employs
science (psychology as a minimum) in its curriculum. My experience is that
there are no prohibitions against using certain words such as "therapy".
As far as I know, there are no prohibitions or reservations, stated or
unstated, against discussing certain topics such as psychology or
- Neither I nor anyone else to my knowledge have been told they were
speaking out of turn. I don't even recollect hearing any new age or pop
culture rhetoric. No one there, for instance, claims to be "healing the
earth". I don't recollect either overt or covert references to any
assistance from supernatural powers for healing patients (although
patients are invited to make use of the VA chapel and religious
facilities.) I haven't heard anyone promoting the use of such things as
therapeutic touch or psychic powers, as I have at AIM. I haven't asked
about any studies of recreation therapy's effectiveness, but I would
assume this has been addressed on the academic side over the years.
- Also, I don't think the recreation therapists view themselves as
artists or that art is of any substantial value over say, good supportive
interpersonal relationships with the patients, which they seem to
concentrate on. That is not to say however that AIM people don't do the
- In AIM, the terms "art" and "creative" seem to be employed very
broadly, which may be a cultural adaptation to maintain our identity in
the medical world, or perhaps it is just the general perspective of people
in the arts.
- In short, the recreation therapy people function as a competent
established profession and, on the face of it, I don't see that there are
any particular advantages to AIM's patients attributable to AIM's broader
perspectives or claims of greater healing powers. This is of course said
without the advantage of having the results of any comparative studies on
the subject, or knowing what processes may be taking place, or may be
effective, in the supernatural realm.
SUMMARY OF CHARACTERISTICS
- Let me now summarize some of AIM's leading characteristics:
- It is strongly anti-science and anti-mainstream-medicine in tone; as
evidenced by all of the principle people in the organization: (1), John
Graham Pole with his ennui with scientific writing, his refusal to employ
studies of the effectiveness of AIM modalities of healing, etc. His
comment at a meeting that he was strongly dissatisfied with the course
established medicine is taking. (2), Mary Lane simply makes no pretense at
either being scientific or having any such interest. She prefers to block
the use of the word "therapy", as it applies to AIM. (3), Tina Mullen
prefers not to do comparative studies of the effectiveness of AIM
modalities of healing and she will not hire anyone in the "therapy"
professions. (4), Don Lutz believes mainstream medicine is a failure
compared to alternative, holistic or vegan modalities of healing.
- There are substantial overtones eluding to unique supernatural powers
among many AIMers. Mary Lane is the chief proponent. She heals the earth
and employs considerable new age and pop culture rhetoric otherwise
eluding to such powers. John Graham-Pole's writing is less overt in this
area but I think a reasonable assessment of his writing and what he has
said places him in this category so also.
- There are cult characteristics. Topics that may be addressed at any
scheduled forum are strictly limited. Refusal of administrative staff
to discuss issues. Barring the therapy professions (thus contributing to
isolation). Vilifying science, therapy, mainstream medicine.
- Although there are 700 doctors alone at Shands, outside of the
founders there are no medical people or others with a hard science,
mainstream medical, or scientific research background otherwise (outside
of myself) active in the organization.
- Virtually no research into the effectiveness of AIM modalities of
healing has been done to my knowledge, with the possible exception of the
maxilo-oro-facial surgeon's work.
- AIM rhetoric vastly outpaces what it could ever be proven to
- July 3, 1999, update Cult Character of Shands
Arts in Medicine Program Continues .
ANALYSIS OF THE ABOVE CHARACTERISTICS
- AIM is now nine years old. Over this time, it has chosen to snub the
dirt-work of clinical trials, the scientific method, and all the time
proven standards of objectivity required of credible scientific research
into its effectiveness, in favor of pretentious language and allusions to
supernatural powers, to establish and promote its effectiveness.
- In order to proceed with such an unlikely modus operandi in the middle
of a scientific community, it has drifted increasingly toward certain cult
like behavior, exploiting negative stereotyping between the arts and
sciences; resulting in vilifying those disciplines that it considers to be
a threat to it. These include mainstream medical science, psychology and
the "therapy" professions.
- Indeed, many of AIM's founders and lead people have varying personal
reasons to keep AIM out of the mainstream that are at odds with the best
interests of the organization. This phenomena is not uncommon for small
growing businesses and other enterprises. The founders have the vision to
get them started but that same vision turns into a liability as the
organization grows and matures.
- In its personnel practices, whether paid professional person or
volunteer, it must find administrative and other professional people who
will accept, and are otherwise sufficiently compatible with, this modus
operandi. Of course, the bulk of volunteers don't get this deeply into the
character of the organization so it doesn't affect them and in any event,
it takes some time to comprehend the dynamics of the organization; in my
case, something like a year.
- Viewed as a new profession making its way in a competitive world, it
is proceeding with two totally crippling self inflicted strikes against
itself. First, it is flouting all of the conventions of scientific
research it needs to establish its value, compared to, for instance, the
therapy professions. Second, it is isolating itself from the therapy
professions and other things it sees as a threat; thus depriving itself of
valuable knowledge, both for its own use, and to assess its competition.
As time goes on, it will become increasingly dependent upon such isolation
requiring further vilification of the therapy professions, mainstream
science, and psychology to maintain itself.
- Currently, AIM is riding the crest of a national and world trend as
evidenced by the Patch Adams phenomena which may effectively blunt any
criticism for the time being. However, as time goes on, and Gainesville
AIM of necessity continues to become increasingly isolated and defensive
it will probably sooner or later run into trouble with its host hospitals
or perhaps it will be seen to be less effective than the therapy
- I would think its strongest suit is its unpaid volunteers which are
relatively plentiful in this university town, or its very modestly paid
artists in residence, for here I would assume there is currently minimal
competition. In any event it is inevitably heading for its eventual demise
unless it changes course.
GETTING ON TRACK
ART AND SCIENCE AS MUTUALLY SUPPORTIVE COEQUALS
- AIM people tend to think of mainstream medical science as a culture
with various negative connotations-- male dominated, self serving, narrow
minded, dysfunctional, repressive toward holistic modalities of healing,
- I am convinced this has much to do with why AIM has avoided employing
science even though, as discussed in the three points at the beginning, it
has so many critical needs for it. At the same time however such negative
cultural perceptions are obscuring the fact that science itself is merely
a method. And viewed as a method, any such cultural perceptions are simply
irrelevant, true or not.
- Science does not and can not address supernatural phenomena, whereas
AIM people often invoke the supernatural in various contexts. This is
another area that often indirectly leads to misunderstanding between art
and science people and is unquestionably an element in AIM's propensity to
circumvent science and science people.
- What is needed is a comprehensive contemporary cultural, religious,
scientific and philosophical ideological profile of AIM that successfully
addresses these issues where the roles of art, God and science are
portrayed as mutually supportive. It would of course meet cultural and
legal standards for Shands and the University of separation of church and
- I believe such a profile could be constructed through discussions with
academics in the above and other fields. It could then be available for
AIM seminars and possibly orientation for new volunteers. (This was one of
the projects I was pursuing but dropped when I realized there might be a
negative reaction to it).
ESTABLISHING SCIENCE WHERE APPLICABLE
- The scientific method needs to be established. This might seem obvious
enough but it also means that (1), all healing modalities are not equally
effective (2), the scientific method is the final arbiter of the value of
any healing modality; and (3), the results of credible research needs to
be respected within AIM.
- Although this is the norm in the medical and scientific community in
general, I know it would be a hard pill for many in AIM to accept because
of the negative connotations that mainstream medical science has for many
of us and the interest in alternative healing modalities that many of us
have, some of which don't look very good under scientific scrutiny..
- At the same time of course this does not mean that established
positions can't or shouldn't be challenged. Indeed, once it is
established in the scientific community that AIM is willing to play by the
rules, this might be where AIM could make a very valuable contribution.
But we could scarcely be credible critics of the medical community when we
are at the same time making wild claims as to our value while flouting all
the rules of sound research.
RESEARCH AND RESEARCH PERSONNEL
- In the complex world of so many different healing modalities, AIM is
clearly in the controversial end of it. Thus, if for this reason alone, it
is incumbent upon AIM to do the soundest most credible possible research.
And the key here is to have the assistance of the best possible research
people with established track records of competence and integrity. I would
assume this would include various specialties in art, psychology,
medicine, and social and medical statistics, to mention a few. Mary Lane
is currently director of research for CAHRE, the University's research and
education arm for AIM. She might consider stepping down if such a person
with strong research credentials could be found.
- At the same time, this is not to suggest that AIM needs to turn into a
research factory. Simply to recognize the need and actively seek the
participation of such people would be a very worth while step in the right
direction, indicating AIM is prepared to play by the rules, whether any
such research actually materialized in the short term or not.
- AIM's artists in residence work in various fields. Having such people
as mentioned above associated with their work would be helpful (whether
more formal research should materialize in the short term or not) in both
exploring the mind body connection and in shaping their work (i.e.,
healing) into something that is measurable in terms of the mind body
- I would guess the latter issue is a major one for both holistic
healing in general, and AIM specifically, because the effectiveness of
such modalities probably tends to be more complex to measure.
- I would assume such associations are the norm in medical research and
shouldn't be looked on as invasive but rather an aid to improving AIM's
- AIM as a discipline is a broad amalgamation of art and science with
few established rules and procedures making it very vulnerable to being
employed as a vehicle, consciously or unconsciously, to further people's
own goals and psychological needs at the expense of solid development of
AIM (where this would not be possible in the relevant established art or
medical disciplines from which AIMers come.)
- In other words, are the pretentious new age rhetoric, commercialism,
vast overstatement, supernatural leanings, etc., and other trappings of
quackery that abound in AIM the result of people escaping from
restrictions on such things in their own established professions?
- Thus I am suggesting it would be a good idea for those in AIM to
examine their own goals, interests, psychological needs, etc., so that AIM
may be accorded the same respect, as a fledgling discipline, that is the
norm in those established disciplines from which AIMers come. Of course
there will be some variations from one discipline to another, but I have
difficulty seeing that it should be anything like the variation that
currently exists in AIM.
- For some perspectives on this, see for instance,
Why Health Professionals Become Quacks .
PROBLEMS WITH PSYCHOLOGY OR THE THERAPY PROFESSIONS
- If there is in fact a problem with these professions or their
knowledge base, the matter should be objectively examined; which of course
could be accomplished in many different ways.
CLAIMS AS TO EFFECTIVENESS
- Clearly the founders have placed no bounds on such claims; the
rhetoric and the reality being far apart. This needs to be brought into
line with established practice in the medical/academic community.
NEW AGE AND POP CULTURE RHETORIC
- Clearly the founders have placed no bounds in this area as well. This
also needs to be brought within the bounds of established practice in the
- There is a need for bounds to be established on commercialism as
DOES AIM HAVE A UNIQUE NICHE
- I think it is worth exploring the possibility that the function
performed by AIM can be better delivered through one or more other
established professions. This possibility would be particularly valuable
to explore in the instance where education and research may already exist
at UF for them, such as in recreational therapy, or might reasonably be
brought in. As well as recreational therapy, there is art therapy, music
therapy, dance therapy and the more specialized "therapies" such as
physical therapy and occupational therapy; although I don't know how many
of them may be degree programs at UF.
- Of course other host institutions may already have addressed the
issue. However, that doesn't necessarily render an easy answer either,
because the character of AIM in different institutions probably varies a
- The advantages however would be substantial. Being free of the
cult-like, supernatural leaning, isolationist, anti-science,
anti-psychology, anti-mainstream medicine, poor management character of
Gainesville AIM, would open it up to vastly more people from different
walks of life (including science nerds like me), better appeal to Grants
and financial support, and improve the Hospital's image.
- AIM can decide whether it wants to leave research to others or go into
research. In either event, it needs to make substantial changes if it is
to survive over the longer term. The changes can be according to the
discussions laid out in this Web site or some other reasonable source.
A FEW PERSONAL OBSERVATIONS
- My first taste of real world science was at Shands in 1962-63. As a
graduate student I did a computer program on the University's IBM 709
computer to determine the radiation dosage in a specified x/y plane from a
radium needle placed at a given location in the body.
- I also wrote a computer program to study the normal distribution of
commonly taken blood values. This was under the Hospital's statistician
who wanted to establish whether the periodic calibration of blood test
equipment could be accomplished from existing blood samples taken from
patients entering the hospital rather than having to go to the trouble and
expense of taking further samples from a "healthy" population.
- To the best of my recollection, all of it had to be designed and
programmed by me from scratch since there were no existing programs that
fit the purpose in those early days. The computer itself was a tube
machine using of course punched cards.
- I loved Shands and working with the medical people on these
applications as well as the magic of my first real world application of
calculus and normal distribution theory.
- I was gone from Gainesville until just recently. Thus when I began
volunteering with AIM about a year ago, I looked forward to returning to
my roots, so to speak, as a volunteer; although I wouldn't have turned
- As to the Web site, there were (and are) no technical reasons why AIM
should not have a good comprehensive organizational Web site absolutely
free of any cost. The site could be placed on any of a number of free
servers, including the Alachua Freenet, which exists for such purposes,
and is entirely free. I am also familiar with it; having this site as well
as my legal reform site on it and having helped others with it.
- In viewing my experience as an example of an AIM volunteer, if AIM's
problems with science, psychology and the therapy professions had been a
little less pronounced, and management had been a little better, there is
no question I would have started a Web site for AIM nine months ago, and
if my experience with legal reform is any gauge, it would now be one of
the most comprehensive and best rated sites on the web. (For anyone with
an interest in the subject, the most recent addition to my legal reform
site is at Lawyers Make Billions at Expense of
Sick and Dying Smokers .)
- As well I could have been involved in research to establish the
effectiveness of various modalities of healing (although I don't have the
background to be a lead person.)
- I also might have attempted to make a contribution in explaining the
nature of science or the relationship between art, religion, and science
so that AIM could have a unifying ideological framework from which to
proceed. And the core of this problem in turn has to do with AIM's
somewhat unique position in having to have a single ideology that must
function effectively in three disparate and, moreover, often antagonistic
cultures; those of art, religion and science.
- However, instead of making such contributions, no one in AIM has ever
been interested in discussing with me how I might make a contribution for
the past year, my offers and papers have been ignored (again poor
management); all of which rendering me largely dysfunctional in the
organization. This is not to say that I haven't been requested to do a few
simple tasks such as surfing the Web for information or making a minor
contribution to the Shands Hospital AIM Web site.
- And AIM is very likely foregoing the contributions of a great many
people because of its idiosyncrasies. Thus many people are not being
helped that might otherwise be, particularly when considering the
popularity of the Patch Adams phenomena; a great aid for enlisting
volunteers from all walks of life, as mentioned previously.
- Of critical importance, is management. As far as I know, none of the
AIM people have any formal background in organizational management and I
doubt there are any with much practical experience in management.
- The perception seems to be that anyone in a supervisory position (or
anyone in the organization otherwise) has to be an "artist" of some kind.
This idea doesn't hold water. For instance both of the two major computer
companies, IBM and Apple, when they ran into trouble, hired people as CEOs
with little background in computers. They were hired for their
organizational, people, and marketing skills; the same skills that AIM
- If AIM had a retired university administrator, retired corporate
manager, grad from a useful related field such as recreation therapy or
other experienced administrative or management type to take the reins,
she/he could concentrate on bringing in all of the talents and skills
necessary to provide the organization with the balance required to
function well in what it now does and expand into a host of new areas. And
with the current popularity of the AIM concept, I suspect many of them
could be enlisted as unpaid volunteers.
- I love the AIM concept and its people, and indeed you will not find a
bunch of more dedicated people or more enjoyable people to work with. But
the ideology and modus operandi are grossly dysfunctional; a classic
example of an organization run by founders, wonderful people, who had the
vision to get it started but who are now holding it back.
- Most of the material contained in this site would be barred from
discussion within AIM and thus I am a sufficient enough realist to know
this Web site will make little difference in the short run. But over the
longer term, I am a strong believer in the power of a free market for
ideas and I know it will make a difference, as I know my legal reform site
- For as a fledgling concept and discipline, the concept of AIM deserves
better than to be lead astray or discredited through self interest or
quackery, but rather to have a sympathetic and nurturing home whether that
be through current AIM, art therapy, recreation therapy or something else.
- And of course I very much hope this site will make some sense to my
friends in AIM.
- And I hope it will make some sense to other organizations that may be
facing similar problems; and thus make some modest lasting contribution to
this wonderful concept.
- "It's the action, not the fruit of the action, that's important. You
have to do the right thing. It may not be in your power, may not be in
your time, that there'll be any fruit. But that doesn't mean you stop
doing the right thing. You may never know what results come from your
action. But if you do nothing, there will be no result."
Copyright © 1999, Robert Allston. All rights