Patient and the hospice: Defining a new era of oncology hospice architecture through the Sri

Lankan sense of built environment.

Human body is considered as the most complex machine which could ever be found on the earth. With
this complexity, many malfunctioning of the system would arise due various causes from the
environment. These malfunctions usually occur either physically or mentally. With these
malfunctioning or illness of human, societies had started various techniques and practices to restore the
ill person back to its normal state; usually known as curing or healing. This practice is normally called as
medicine and is further defined by the Dorland's Medical Dictionary as;

The art and science of the diagnosis and treatment of disease and the maintenance of
health.

A hospital in western medicinal practice usually occupies with more materialized and industrialized
environments; thus, causes many inconveniences to the hospitalized patient. According to Wikipedia,
the free encyclopedia, this catastrophe has been described as,

One criticism often voiced is the 'industrialized' nature of care, with constantly shifting
treatment staff, which dehumanizes the patient and prevents more effective care as
doctors and nurses rarely are intimately familiar with the patient. The architecture
and setup of modern hospitals often is voiced as a contributing factor to the
feelings of faceless treatment many people complain about.

With all these criticisms and the lack of holistic medicine concept scientists tried to define new concepts
on the healing process, other than using the one and only pills and technology for the healing
process. They have seriously inspired by the traditional Eastern Concepts. The Journal of Advanced
Nursing once had an interesting article about the philosophy and physics of holistic health care. This
article reveals that many Eastern healing practices have occupied the environment for its curing
process. One such citation is;

For Thousands of years the Chinese have observed life process and relationships
between man and his environment. From this observation, the art of Chinese
medicine has developed vocabulary to describe myriad subtle body patterns….not
available to Western medicine because of its emphasis on disease states.

The experiments on the environmental impact for the healing process has been started during 1984.
Esther M.D’s Healing Spaces defines this as;

The idea that physical space might contribute to healing does, it turns out, have a
scientific basis. The first study to tackle this question, published in science magazine in
1984, showed that when hospital rooms have windows looking out on the natural
world, patients heal more rapidly.

This observation aroused many questions on how could it happen? Esther tries to explain the
physiology of the body as described in neuroscience. She explains how perception, hearing, sense and
all of these things contribute to the healing function of the body. This book however concludes that
having pleasant environments with reduced stress would be grateful for a patient to recover. Further it
criticizes that it the task of 21st century to create hospitals with healing environments.

Understanding and reducing stress in the hospital environment is to twenty-first-

century medical care what understanding germ theory and reducing infection were to
nineteenth-century care.
When it comes to cancer patients, the issue becomes more serious because of the nature of disease. A
citation acquired from an article of Journal of Clinical Nursing says that,

Cancer, when perceived by patients as a life-threatening illness, contributes to spiritual

suffering. McGrath (2002) conceptualized spiritual suffering as spiritual pain, meaning
that individuals experience conflict and disharmony between their positive belief
systems and the reality of their current situation. Spiritual suffering influenced
patients’ abilities to cope with terminal cancer effectively because it contributed to
impairments in patients’ connectedness, faith and religious belief systems, value
systems, meaning and purpose in life, self-transcendence, inner peace, harmony, inner
strength and energy (McMillan & Weitzner 2000, Villagomeza 2005). Previous studies
have examined how to enhance patients’ spiritual well-being, the causes of spiritual
suffering and strategies to heal suffering.

The model of Optimal Healing Environment emerges in order to accommodate this new concept of
healing. The journal of alternative and complementary medicine defines the optimal healing
environment as;

The approach to issues of meaning in an OHE, or any medical environment, depends at

a deeper level on the philosophy of healing. Healing, in our view, allows patients to
reconnect with purpose and meaning in their lives by freeing them, as much as
possible, from pain; by reducing fears and fostering biological wellness to
enable deeper engagement with living; and by encouraging the examination,
repair and resolution of relationship issues that come to light in the course of
grappling with disease. Passion, humor, celebrations, and playfulness also hold
a place in the healing process, as constant immersion in emotional heaviness
and clinical detail is unhealthy and unproductive for both healers and patients.

Architecture plays the vital role of creating an environment for the patients which allows them to be freed
from the stresses they have. This can be achieved easily with the implementation of the Sri Lankan
tradition of architecture. For example, in the book Landscape Tradition of Sri Lanka, prof. Nimal De
Silva points out that;

The Secular Approach with a high degree of aesthetics and pleasure found in the
royal gardens of gold fish park in Anuradhapura……………………………gives an
indication of the consciousness that the royalty and their architects possessed in
creating garden architecture by integrating the organic forms of the natural settings
with an axial symmetry, the trees, boulders, moving and still water, the topography and
terracing as an outcome of the accumulated wisdom of the past.

What can now be done is identifying the characteristics and detailing of pleasurable and calm
environments with special reference to landscape, public spaces, private spaces, pathways, etc which
has been used in the ancient architecture of Sri Lanka.
References

Esther M. Strenberg, M.D Healing Spaces: The Science of Place and well being, London, Harvard
University Press, 2009.

Malkin, Jain Hospital Interior Architecture: Creating healing environments for

special patient populations, New York, Van Notstrand Reinhold, 1992.

Wijesuriya, Gamini Buddhist Meditation Monasteries of Ancient Sri Lanka, Sri Lanka,
Department of Archaeology, 1998.

De Silva N. Landscape Tradition of Sri Lanka: Philosophy, principles and practices,

Sri Lanka, Deveco Designers & Publishers (Pvt) Ltd., 1996.

Elissa F. Patterson The philosophy and physics of holistic health care: spiritual healing as
a workable interpretation, Journal of advanced Nursing 27, 287-293,
1998.

JEREMY R. GEFFEN, M.D. Creating Optimal Healing Environments for Patients with Cancer and
Their Families: Insights, Challenges, and Lessons Learned from a
Decade of Experience, THE JOURNAL OF ALTERNATIVE AND
COMPLEMENTARY MEDICINE, Vol. 10, Supplement 1, Mary Ann
Liebert, 2004