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By GK Rowe, XD

Many of us Gen Xers are at t he cusp of caring for our communit y in a time
when our healt hcare system is at the edge of a major breakt hro ugh or o n
the verge of a major breakdow n. As a result, there are mult iple concepts
gaining progress relat ed to aesthet ics in the healt hcare e nvironment. One
of these earliest concepts is Evidence -base d Design or Evide nce-based Art.
“Evidence-base d Art is the process of basing decisions about art in healt h-
care on credible re search to achieve the best possible outcom es.” The
quest ion should be what is the credible research? Art ist and physician,
Henry Domke, MD has an art icle o n his blog title d W here’s the Beef? The
Evidence for Evidence-based Art and D r. Rut h Bre nt Tofle suggests
“designers are embracing it witho ut realizing that this is such a new field
that we don’t know much [abo ut] yet.”

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While Evidence-based Art has elevated the importance
art plays in the enhanced care of patients, I think much
of the research lacks the inclusion and credentials from
fine art professionals. Within my studies of Evidence-
based art, there is little attention given to art educators,
artist, curators or historians; yet, when you compare the
studies done in neuroscience with art history, it is
apparent that science is behind the times when it comes
to understanding the relationship between woman or
man and art. With the advancement of technology and
neuroscience, scientists are rapidly gaining more
information about the master “minds” of artists. Most
of the findings in Evidence-based Art today are done
through controlled-group questionnaires developed from
healthcare professionals, academics and art consultants.
While their findings are significant, I think it is danger-
ously premature to begin establishing standardized
processes used in patient-focused aesthetics. Making
The research presented fails to comprehensively
such claims as “abstract art is the worst” is inconsistent
examine the evolutionary process of art and its impact
with our cultural evolution with visual images. Further-
on modern societies to more specifically enhance
more, there is power in both knowledge and fear and I
patients’ recovery through a process inclusive of
would suggest that many art consultants will be eager to
nueroaesthetic concepts and experience design
own a piece of this conceptual pie.
Formulating guidelines for Evidence-based Art is
Taking a look back 30,000 years ago to the time when
problematic because it attempts to define measureable
Nomadic people started making statues and images of
outcomes based on a fraction of information gathered
the human body, we can begin to understand our con-
under diverse situations. According to studies reported
nection to abstract art. The Venus of Willendorf, a
by the Center for Health Design: A Guide to Evidence-
relic of our ancient past, provides the first clue as to
based Art by Kathy Hathorn, MA, and Upali Nanda,
why our modern world is so dominated by unrealistic
Phd., reports “In the Biological Origins of Art, Aiken
images. The Venus of Willendorf’s features are gro-
(1998) makes a scientific as well as philosophical
tesquely exaggerated with the breast, stomach, hips,
argument for the emotional impact of art and its impor-
and thighs prominently enhanced. Carved with great
tance to humankind’s survival as a species.” Art has
care, the statue has no arms and the face is non-
been an integral component of human evolution, both as
existent. The statue would have been easy to carry and
a species and as a society. The report presents that
may have served as a symbol of fertility or mother-
images of nature are more appropriate in healing art
hood. These features provide clues as to what was
based on the concept of “biophilia,” which was coined
most important to the Nomadic peoples that lived in the
by Edward O. Wilson. Dr. Roger Ulrich, Ph.D., EDAC,
harsh ice-age environment where fertility and fattiness
further interprets this by explaining that “humankind’s
would have been highly desired. In our modern soci-
evolutionary survival skills in a natural world have hard-
ety, we live in a world of abundance and can see exam-
wired humans to find nature calming and restorative.”
ples all around us where we have continued to empha-
Furthermore, it is suggested that as modern humans we
size those features we most desire that are extremely
have an inherent connection to nature derived through
our ancestors.

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contradictory to the environments in prehistoric times As one of the first settled civilizations, the Egyptians
which was mostly defined by scarcity. It would be un- relied heavily on agricultural means of survival and
realistic to claim that modern people respond to the adopted behaviors that led to the investigation and ex-
same types of images that were important to their ploration of mathematics as it related to the human
ancestors particularly if the images reflect our relation- body. Their visual communication reflected that which
ship to the environment in which we live. While early was most fundamental to the civilization’s survival
hunter-gatherers valued and emphasized fertility and which thrived through structures, organization, and
fattiness in their culture, our modern knowledge-worker order. The images created consistently depict the
culture values are expressed in vastly different ways values of their culture for more than 3,000 years until
than those defining the Venus of Willendorf. “Over Egyptians started trading with the Greeks by way of the
10.2 million cosmetic surgical and nonsurgical proce- Mediterranean Sea.
dures were performed in the United States in 2008. The
overall number of cosmetic procedures has increased The ancient Greeks were preoccupied with mathemat-
162 percent since the collection of the statistics began in ics and philosophy and with a fixation on perfection
1997. The most frequently performed nonsurgical and beauty of the human body, inspired by their belief
procedure was Botox injections and the most popular that Gods took human form. Similar to the Nomadic
surgical procedure was breast augmentation.” This ancestors approach and purpose, the Greeks developed
statistic alone reflects the values most important to our a highly skilled athletic body – filling their temples
modern culture and the ways in which we have with life-like statues of their Gods and Goddesses to
embraced aesthetics. As our modern society became achieve an exaggerated reality; thus, exemplifying the
more culturally diverse, what we chose to exaggerate values most important to their culture.
changed even further. Similar historic references to the
use of visual images are evident in the advancement of It wasn’t until the Renaissance period, late 14th to early
societies from gatherer-hunter to the conceptual age. 15th century, that art became Art and the creative
thinkers gained the ranks of the elite and established
themselves as Artists. Simultaneously, the influence
of religion and humanism integrated with power and
authority, gave way to narrative imagery with allegoric
references throughout the Renaissance. Italy would
experience the bubonic plague or the “Black Death”
which would affect the economy, cause rapid
expansion of hospitals and stimulate commissioned
work of religious images.

Most of the theories developed for Evidence-based Art
encourage the use of natural images derived from
evolutionary concepts that support human connection
to shelter and protection instilled from our ancestors;
and, through emotional congruence or mood-
congruence processing which implies that in a stressful
situation negative emotions are likely to be projected
on to the surrounding environment by a patient, which
explains the adverse reaction to abstract or ambiguous
art. The Guide for Evidence-based Art reports,

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“Visual art can be traced as far back as the Paleolithic The Peak-Shift theory, a principle in animal discrimina-
man’s cave art and continues to be an integral part of tion, helps explain human pattern recognition and
people’s live[s].” It’s a small wonder then, that the use aesthetic preference. This is a fundamental resource to
of art in hospitals dates back to the 14th century, when consider when practicing Evidence-based Art to fully
they were church operated. “ While it is apparent that understand human experiences with works of “art”
Prehistoric humans had an affinity to their environment from the Paleolithic period to modern day culture.
especially as it pertained to shelter and protection, it is This theory gives insight to behavioral responses to an
more important to evaluate the relationship between aesthetic environment as it relates to survival. The
artist and woman or man. It is also important to note study, using herring gulls, was demonstrated to explain
that viewing appropriate nature images can reduce stress neuro responses to abstraction. Adult herring gulls
and reduce pain as reported through psychological have large yellow beaks with a red dot that is signifi-
testing and self-reporting surveys. So, why have we cant to the visual response from herring gull chicks as it
spent years producing abstract images that reflect our relates to their survival. The process of how young
most fundamental values when they are reportedly chicks respond to their mother’s beak for food is an
inappropriate for enhancing our connection to our important principle in understanding the evocativeness
recovery process in a healthcare setting? Jeff Hawkins, of much of visual art. When an adult herring gull has a
founder of Redwood Center for Theoretical Neurosci- grub in its beak, young chicks respond by opening their
ence suggests, “Modern art, in its tendency toward mouths wide and cheeping excitedly. This might seem
abstraction, does not depict anything less realistic than like intelligent behavior on the part of a hungry young-
art that depicts a human form or any other place or ster seeing food, but herring gull chicks are not very
object in a more photo-realistic manner. Rather, it is intelligent. If the red spot was painted yellow, the
just depicting a different place in our brain: a place be- chicks ignore the food. Show them an empty beak with
tween the invariant (photo-realist) representations at the a red spot and they gape and cheep as before. In fact a
top of hierarchies, and the essential, raw sensory data of bright red dot on a vivid yellow pencil elicits extra
incoming input.” strong gaping and when presented with the option of
large yellow stick with three red bands, the chicks
favored the more abstract over the mother’s beak.
Applying science to the arts expands the “evidence” in
Evidence-based Art principles by identifying more
acutely the impact art can have on clinical and
behavioral outcomes for patient focused aesthetics. V.S.
Ramachandran, Director of the Center for Brain and
Cognition and Professor with the Psychology Depart-
ment and Neurosciences Program at the University of
California, San Diego, is best known for his work in
behavioral neurology. Ramachandran has explored the
connection between the brain and art and has begun the
investigative journey with the four-inch oolitic lime-
stone sculpture Venus of Willendorf to better understand
the “human artistic experience and the neural
mechanisms that mediate it.” Ramchandran uses the
Peak Shift Theory to explain the behavioral response to
images as they relate to life’s most fundamental

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The peak shift effect can be applied to human can be different from how they think they do or what
recognition and aesthetic preference throughout the they say. There needs to be more quantitative data
history of man creating images. Consider the way a collected through neuroscience to make these types of
skilled cartoonist produces a caricature of a famous face. judgments; that said, since we all judge the world
The cartoonist takes the average of all faces, subtracts it through our own experiences it may be that we will
from the subject’s face and then amplifies the never be able to properly define what artwork is
differences to produce a caricature. The final result is a appropriate for a patient other than the patients them-
drawing that is even more like the original. The selves. For now, it is important to continue the dia-
cartoonist uses the same fundamental principles learned logue between artists and scientists about the possibili-
and used by the Nomadic peoples to create the Venus of ties and limitations surrounding aesthetics in health-
Willendorf. In our modern culture, we respond to care. Reports indicate that less than two percent of
caricatures in much the same way sea gull chicks design decisions are based off of solid evidence.
responded to the exaggerated abstraction of their Evidence-based Art is significant to the role art will
mother’s beak. It can be argued that a Picasso portrait have in the future development of healthcare facilities.
is nothing more than a caricature - when you compare Having the best research is not enough. It is imperative
the subjects to the paintings, their similarities become to the process that observations, insights and practices
obvious. carry over to advance aesthetic decisions. At the end
of the day, I think all art consultants that work in the
“Despite all that has been said, there might appear to be healthcare industry should be participating in the
an important disanalogy between science and art. practices of Evidence-based Art by continuing to learn
Scientific understanding has an object – the natural as much as possible about the field by implementing,
world or physical universe. This is what the scientists’ evaluating and questioning the research to improve and
theories are about. But we have yet to state clearly what enhance the aesthetic environment in healthcare.
artistic understanding is about. In terms of focus, an
artistic process is concerned with issues of look-and-
feel, whereas a scientific approach focuses on deeper,
more systematic issues like underlying architecture. In
terms of methodology, art relies on intuition and experi-
ence, whereas science depends on rigorous investigation
and analysis. In terms of validation, an art-led process
often rests on subjective or personal evaluation, whereas
a process that’s grounded in science relies on rigorous
testing using quantitative metrics.”

I don’t disagree with the concept of nature-based art and
being sensitive to subject matter that will potentially
enhance a patient’s recovery process; however, I’m not
convinced by the data presented that “ambiguous or
detrimental visual elements (including art) may have
emotionally, and even physiologically, harmful
effects.”12 Most of the data collected has been through
focus groups, questionnaires and surveys, which are Artwork by Alex Hughes
poor tools for learning about behavior since they are
documented by actual use; and, what people actually do

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GK ROWE, XD is an Experience Designer and Principal Partner, TIFFANY GARRITANO is the lead for graphic and web design for
Director of Creative Development for Q7 Associates a multimedia Q7. Her experience as designer, webmaster, art director, project
marketing and design firm located in Indianapolis Indiana. GK has manager and copywriter allows her to creatively deliver effective
formal education in Fine Arts, Design, Natural Wellness and solutions. She also helps solidify Q7's unified cross-platform
Education including studies abroad in Italy, London and Paris. He marketing strategy by having a combination of design and techni-
continues to infuse creative solutions and experience design cal knowledge. By designing for communication, she ensures that
concepts into the business world through multidiscipline all projects exceed client objectives and inspire a wide range of
mediums applying neuroaesthetics in the healthcare, hospitality audiences.
and corporate industries.

Committed to a higher level of aesthetics, GK serves as the
President for the Indianapolis Museum of Contemporary Art
Society, co-developed the art program for the InterContinental
Chicago-O’hare hotel and continues to support art education as a
faculty member at the Art Institute of Indianapolis and is a
member of the National Arts Education Association.


Domke, Henry. "Where's the Beef? The Evidence for
Evidence-based Art". Health Care Fine Art. May 2006
Gordon, Graham. Philosophy of the Arts: An Introduction to
Aesthetics. New York: Routledge Taylor and Francis
Group, 2005.
Jeff , Hawkins. "The Cellular Architecture of Abstract Art".
The Beuatiful Brain. 2009
SCOTT ALLEN TUCKER is a Principal Partner, Director of Media
and Communications for Q7 Associates. Degreed in Telecommu-
nications and English, Scott has worked in a multitude of business Kathy, Hathorn. "A Guide to Evidence-based Art".
and marketing development projects. From the sets of independ- The Center for Health Design 2008: 1-20.
ent films to the conference rooms of corporate America, Scott "Liposuction No Longer the Most Popular Surgical
possesses a wide array of talents within the communications Procedure According to New Statistics". American
field. As a writer, Scott has experience in screenplays, training Society for Aesthetic Plastic Surgery. 2008
manuals, marketing content and magazine publications, copy <>.
editing and content management. He has also worked as a Peck, Richard. "Emerging trends in healthcare". Health Care
director, actor and producer for various film and video projects. Design Magazine March 30, 2010.
Scott oversees the content development for clients’ projects,
V.S., Ramachandran. "The Cellular Architecture of Abstract
including any media and press.
Art". The Journal of Consciousness Studies. 1999