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, 1999.

  1. 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.


  2. 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.


  3. AIM is also inextricably involved with various scientific disciplines in three fundamental ways:

    1. 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.

    2. 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 investigation.

    3. 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.


  4. 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.

  5. 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?


  6. 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.)

  7. 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.

  8. 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.

  9. 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 doing.

  10. 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 well.

  11. 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.


  12. 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.

  13. There is an article entitled Dr. Artist on the Web, from a Gainesville newspaper, the Moon, quoting Dr. Graham-Pole.

  14. 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.

  15. 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.

    1. Creative Healing

    2. First Ph.D

    3. About the Book: Creative Healing

  16. 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.

  17. To understand the issue a little further have a look atCommon Questions About Science and "Alternative" Health Methods.

  18. It is also instructive see Why Bogus Therapies Often Seem to Work .

  19. 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.

  20. 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 them.

  21. 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).

  22. 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.

  23. 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.

  24. 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.


  25. 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.

  26. 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.

  27. 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.

  28. 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.

  29. 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.

  30. 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.


  31. 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.

  32. 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.

  33. 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.

  34. 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).

    1. 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.

    2. 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 them.

    3. 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 might be.

  35. 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.

  36. 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 study schedules.

  37. 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 performs such things as writing for various organizational purposes and coordinates various projects and programs for Arts in Medicine.


  38. 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.


  39. 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 controlled.

  40. 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.


  41. 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.

  42. 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 experiences follow:

    THE "T" WORD

  43. 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.

  44. 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".

  45. 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.

  46. 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.

  47. 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.


  48. 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.

  49. 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 speak.


  50. 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.

  51. 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.

  52. 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?

  53. 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.

  54. 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 discussions often.

  55. 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.

  56. 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 the issue.


  57. 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.

  58. 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 members.

  59. 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.

  60. 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 matter.


  61. 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.

  62. 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.


  63. 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 no attention.

  64. 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 follow suit.


  65. 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.

  66. 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.

  67. 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.

  68. 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.

  69. 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.

  70. 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.

  71. 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.

  72. 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.


  73. 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.

  74. 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 have.

  75. 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.


  76. 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 other.

  77. 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.

  78. 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.

  79. 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.

  80. 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.

  81. 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.

  82. 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.

  83. 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 know.

  84. 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 science.

  85. 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.

  86. 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 same.

  87. 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.

  88. 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.


  89. Let me now summarize some of AIM's leading characteristics:

    1. 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.

    2. 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.

    3. 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.

    4. 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.

    5. 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.

    6. AIM rhetoric vastly outpaces what it could ever be proven to deliver.

    7. July 3, 1999, update Cult Character of Shands Arts in Medicine Program Continues .


  90. 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.

  91. 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.

  92. 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.

  93. 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.

  94. 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.

  95. 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 professions.

  96. 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.



  97. 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, etc.

  98. 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.

  99. 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.

  100. 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 state.

  101. 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).


  102. 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.

  103. 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..

  104. 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.


  105. 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.

  106. 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.

  107. 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 connection.

  108. 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.

  109. 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 healing effectiveness.


  110. 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.)

  111. 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?

  112. 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.

  113. For some perspectives on this, see for instance, Why Health Professionals Become Quacks .


  114. 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.


  115. 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.


  116. 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 medical/academic community.


  117. There is a need for bounds to be established on commercialism as well.


  118. 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.

  119. 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 great deal.

  120. 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.


  121. 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.


  122. 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.

  123. 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.

  124. 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.

  125. 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.

  126. 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 down employment.

  127. 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.

  128. 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 .)

  129. 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.)

  130. 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.
  131. 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.

  132. 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.

  133. 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.

  134. 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 currently lacks.

  135. 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.

  136. 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.

  137. 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 has.

  138. 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.

  139. And of course I very much hope this site will make some sense to my friends in AIM.

  140. 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.

  141. "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."

    ________________________ GANDHI

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Bob Allston

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