Jonathan Parker Abramson was an energetic, red-haired child, so full of life that it seemed to radiate from him. He loved running along the Esplanade in Carl Schurz Park in New York, his little arms pumping. Like many young boys, he loved to play sports and music. He had an easy, infectious giggle. Nurses recall his flushed, cheerful face as he entered their ward, and how he began to resemble a little Buddha as his hair fell out and his features swelled from chemotherapy treatments. In 1981, Jonathan died from a malignant brain tumor. It was four months before his fifth birthday.
This little boy's death has served to bring together two cultures. Since 1996, Beth Israel Medical Center, on Manhattan's Upper East Side, has maintained a dialogue with experts in alternative and Eastern medicines, including the Dalai Lama, in an effort to provide its patients with more compassionate care. The hospital took a step toward furthering that goal with the unveiling of the Jonathan Parker Abramson Safe Harbor, a monument to one courageous little boy, in a space consecrated by the controversial spiritual leader of Tibet.
The new initiative began three years ago, when Dr. Fred Epstein, a neurosurgeon, joined the staff of Beth Israel. With Dr. Alex Berenstein and Dr. Matthew Fink, he created the Institute for Neurology & Neurosurgery (INN). Among their goals was to facilitate compassionate healing with holistic care and to marry traditional Western medicine with ancient healing techniques from around the globe. After contacting professor Robert Thurman, a noted Buddhist scholar and friend of the Dalai Lama, Epstein and the other INN doctors invited his holiness to attend the landmark East/West Medical Conference in New York last May. Their goals were simple yet lofty: to develop studies on the clinical applications of meditation, and to research how these two traditions might be integrated to provide the most compassionate care for patients, their families and health-care professionals. "I had learning disabilities when I was young," Epstein says. "So I understand what it's like, and I'm not afraid to look dumb or to try something new."
It was while he was at this conference that the Dalai Lama agreed to consecrate the 14th-floor terrace, which previously had been used to store machinery. It was chosen because Jonathan's father, Alan Abramson, a real-estate entrepreneur and Beth Israel Medical Center trustee, saw how fitting it was that the site overlooked Carl Schurz Park, and the Esplanade that had provided Jonathan with so many hours of joy. After a tour of Beth Israel's pediatric ward and playroom, the Dalai Lama performed a brief ceremony in Tibetan, blessing the space as a sanctuary for healing. The Safe Harbor was underway.
Since the conference, health-care professionals from both East and West have been working out the details of these groundbreaking scientific studies. In conjunction with Tibet House and Columbia University, meditation practitioners will cooperate with scientists to measure meditation's effects in varying therapeutic contexts, including stress management for patients, their families and the nurses who care for them, as well as pre-surgical relaxation and post-surgical recovery. The timelines for these experiments are being finalized now.
In the year since the Dalai Lama's visit, Beth Israel has engaged Dr. Lobsang Rapgay, a leading practitioner of Tibetan medicine and professor of psychology at the Norman Cousins Center at UCLA, to design a series of workshops that would teach meditation techniques to staff nurses. Rapgay finds that the healing meditations he teaches, based on the teachings of Tibetan Buddhism, can help sick children to be receptive to their own condition and less susceptible to distractions as they move through treatment.
Patients sit quietly in a cross-legged posture, their palms resting on their thighs. With eyes open, meditators are urged to simply watch the thoughts that move through their minds, not judging or labeling them. In time, the mind becomes more restful. "Meditation helps both the practitioner and the patient to move into a state of mind that is restful but also alert and aware," Rapgay says. "It helps people to be attuned to each other, and they're more likely to understand what's going on with their treatment. It's very important for these sick children."
In designing the workshops, Rapgay sought to ground the nurses with Western methods such as cognitive restructuring and other psychological styles of intervention, then to use that framework to introduce Eastern methods of healing. Many of the 12 nurses currently attending the workshops have never practiced meditation and have only the barest frame of reference for its use. Most follow one of the more traditional religions, such as Judaism, Catholicism or Protestantism.
Despite this, Rapgay has found the nurses to be dedicated to providing their patients with the most compassionate care possible. "In a long-term setting, meditation can help the children deal with control issues around their illness and allow their pain to dissipate," says nurse Jennifer Caldcleugh. In August of this year, the group will hand in a patient follow-up and final paper. Rapgay will teach one last weekend workshop at that time, and then the 12 original members will school the next generation of pediatric nurses in meditation techniques.
In addition to its stress-management applications, meditation can also be useful in gaining a patient's trust and compliance, and for the management of any pain. Since the patients are small children, and often frightened of the tubes and machinery of chemotherapy, nurses feel that talking with the child directly and then modeling the meditation techniques will help alleviate anxiety. Many of the nurses say they have brought the meditation practice into their own lives to help them connect with people in a broader sense. Nurse Marsha Lehr says it has helped her deal with the recent loss of one of her ward's children. "When you lose someone, meditation helps you deal with the pain and get closure."
The Beth Israel meditation program bypasses the findings of a 1996 National Institutes of Health assessment panel, which found that complementary therapies such as meditation may have healing effects, particularly in the reduction of chronic pain, but that its results are not quantifiable. Of greatest concern were several barriers to the application of complementary therapies, not the least of which is inadequate access to training programs. In addition, the panel saw "a lack of standard methodology to assess the success or failure of these interventions, a low compliance rate on the part of the patient because these interventions are time-intensive, and an unwillingness on the part of some insurance companies to provide reimbursement for certain treatments." It recommended additional research and education.
Alan Abramson wasn't willing to wait for more research. He wanted his dream fulfilled, and hired San Francisco landscape architect Topher Delaney to help. "When I met her," he says, "there was no one else I wanted to work with." From their first meeting, Delaney seemed a natural choice to build the Safe Harbor. An acclaimed designer of healing spaces and gardens nationwide, Delaney brought a special sensitivity to the Beth Israel site as a breast-cancer survivor. "When your body is no longer in control, it changes your view of what time is about and what work is about," she says. "Now, I want to leave the world a better place." So far, her work has brought healing spaces to hospitals in San Diego and Oakland, Calif., and Victoria, Texas.
The Beth Israel terrace garden depicts the bridges of Manhattan in sequence. Each bridge is distinctly different in perspective, subtly communicating Delaney's underlying metaphor of diversity in culture and viewpoint. The design's wit is evident throughout. The bridges symbolically represent the journey from sickness to health and, as a patient crosses that bridge, letters from many languages, including hand signings, are there to provide company. A little farther down , the Statue of Liberty rises through the Brooklyn Bridge, connecting freedom and language. Highway reflector disks interspersed among the bridges catch the light, and everywhere there is something that attracts the eye.
The rooftop terrace has an aquatic theme. The floor, made from sections of colored rubber, has brightly colored fish designs. Along the perimeter of the building is a series of iridescent fishing lures, built into the wall tiles. Fringed Chinese umbrellas provide shade for those who want to rest, while several tables feature creative activities: a tile table for water play shaped like a whale; an octopus table with several bowls filled with sand and a long tube that kids can talk into while someone listens from another tentacle; and a fish-shaped table inlaid with black terrazzo tile and abalone shells, with a map of the world with the longitude and latitude lines forming a chess board. Overhead, wind chimes emit soft, sparkling sounds that make the wind seem human.
Delaney hopes that the playful space will be a sanctuary for Beth Israel's patients and families. She tells a story about a woman weakened from chemotherapy, moving gingerly into one of her gardens in San Diego. As Delaney tried to help her back into the hospital, the woman explained that she came outside every day for the water in the fountain, because it made her feel better, and she was sure it would help her to get well.
It's been a long journey for Alan Abramson, who has been searching for a way to remember his vibrant son for 18 years. Now, on the eve of what would have been his graduation from college, Jonathan's memory will be honored with the Safe Harbor. Sen. Charles Schumer, D-N.Y., was to join Alan and Patty Abramson, as well as their two surviving sons, Adam and Josh, for the official unveiling, and for Abramson, it's been well worth the effort. "To us, it represents an opportunity for closure," he says. "Every day, something good will come from Jonathan's energy and I feel like he will not have died in vain."