A number of years ago, as a consultant to a rural community hospital Healing Environment Committee, I recommended that TVs, piped-in music, and inappropriate magazines be removed from all waiting rooms. Most of the waiting rooms in the hospital opened out into main corridors. The cacophony of the TVs and music combined was disconcerting, interrupting conversation and thought. Although committee members agreed that this was so, some thought that the community wanted and even needed the TV for distraction. They feared a backlash of anger. Discussions ensued, and it was pointed out by some that the choice of a TV program was usually made by one person and others present were expected to go along with that choice, even the level of sound. Another shared the fact that staff picked the music in the laboratory waiting room, patients were never asked. It is important here to note ethnomusicologist Elizabeth Miles' words on the implications of listening to other's music choices. "Any time you listen to music that someone else has chosen you are allowing other people to color your mood and control your body and mind."1 The selection of magazines available was insensitive to the plight of those waiting, some were an insult to their intelligence. None were in languages other than English. After lengthy discussions, it was decided that it would be a worthwhile endeavor to conduct a time-limited trial of media-free waiting rooms and the elimination of offensive magazines. Response boxes with blank page composition books were installed in each waiting room and commentary began to appear. The initial responses were not overwhelmingly in favor of the proposal, but as time went on, the peace and quiet began to be favored. It is always interesting to read invited ongoing commentary and to learn how thoughtful responses influence others in a way nothing else can. Some were surprised to be given a choice; others were grateful for the quiet. Some choice words and advice was shared about the problematic magazines. Then, the committee, in concert with patient and family representatives, began to introduce literature that spoke to this community's citizens: books and magazines about nature, floral design, art, architecture, and photography; short story collections; and literary journals with poetry. In consultation with community teachers, intriguing, appropriate literature was selected for children and teenagers.

Then one remarkable day, I encountered two teenage girls sitting in the Radiology Waiting Area, and wonder of wonders, they were reading poetry to one another from one of the journals in the waiting room. One said to the other, "Wait, listen to this!" And then she read an entire poem to her friend with full inflection and strong voice. Her friend listened intently to her. They never noticed me standing in the doorway.

Today, entering a clinic or hospital waiting room, you will see people looking intently at their cell phones screens[horizontal ellipsis]scrolling up and down, reading and sending text messages and e-mails. Some look quite concerned, and one imagines that they might be dealing with a crisis or a difficult task, both of which take them away from the reality at hand. But of course, there are pleasing messages to be read as well. And then for some, there is the possibility of listening to personally selected music on their smart phones. Patients might have recorded thoughts and questions on their cell to discuss with their healthcare provider. But consider that at this moment in the waiting room, they are in a vulnerable state and need calm to think critically about their health and welfare. Of course, it is up to them to decide if they need some diversion, some respite, and just exactly what that should be. But consider that at this moment in time that the waiting person is in a vulnerable state and needs calm to think critically about his/her health and well-being.

Let me introduce you to an Arts in Health charity in the United Kingdom called Poems in The Waiting Room (PiTWR). Begun in 1998, the project supplies collections of poems of high literary and visual quality for patients to read while waiting to see their doctor. The poetry cards are published quarterly and are a gift to patients should they want to take them home. A key consideration is the selection of poems. Guidelines for the selection of poems have been devised with this in mind and with help from a consultant psychiatrist as well as from poets. In a patient-centered health service, poetry art in health too needs to be patient centered. The readers are patients-the worried well and the worried sick. The poems selected draw from the springs of well-being. In time of trouble, a measure of comfort is welcomed. The selection of poems is therefore different from, for example, the poems that patients may themselves write as writing therapy. Poems selected for inclusion in PiTWR collections are a mix of contemporary work and poems from the canon of English poetry. Translations of poems from other traditions are also included. The essential is that they all contain positive images of hope, home, security, safe journey and arrival, beauty and transcendence, love, and loving. The approach is indeed more akin to bibliotherapy rather than art therapy2 (http://www.poemsinthewaitingroom.org).

POEMS IN THE WAITING ROOM WORLDWIDE

The success of PiTWR in the United Kingdom has aroused international interest. To date, there are projects in Ireland, New Zealand, Columbia, Australia, and Roanoke, Virginia.

In Ireland's PiTWR project, a short collection of poems is supplied for people in waiting rooms in County Kildare. Initially, these are doctor's surgeries, hospitals, and libraries-places the public has to wait. The waiting room is the one place that at, some point, everyone has to pause. It is a room full of strangers, which levels us and where we have a chance to reflect. Poetry can help humanize these impersonal places. And hopefully, some people will take away something more than a brief relief of the boredom or worry of the wait. They will take away a newly awakened appreciation of poetry (http://www.pitwr.blogspot.co.uk).

Poetry in the Waiting Room New Zealand is a Dunedin-based arts in health charity. The aim is to provide a free source of well-chosen poetry for patients waiting for medical appointments; rest home residents waiting for meals, outings, or appointments; hospice patients and their families; and prison inmates. They are selected for reader's enjoyment and are in no way a vehicle for delivering any social/health messages. The cards may be read and left on site or taken away for sharing or further reading (http://www.waitingroompoems.wordpress.com).

Columbia's POMEAS EN LA SALA DE ESPERA was launched in 2013, and their poetry cards accompanied by biographies of the poets are available on their Web site (http://www.pelsde.org).

In the United States, the Dr. Robert Keeley Healing Arts Program of Carilion Clinic in Roanoke, Virginia, provides PiTWR. Copies of the first and second editions are available on their Web site (http://www.carilionclinic.org/healing-arts/programs/poems-waiting-room).

To the Tune: Sands of the Washing Stream

Recovering from sickness

with tangled hair,

I lie and watch

through the window screen

a slim moon rising.

I simmer pods of cardamon

in place of tea.

Reclining on my pillow,

reading ancient poetry

restores me.

Outside

healing rain arrives;

elegant cassia flowers

bow towards me.

Li Quingzhao

(China, 1084-c. 1150)3

References