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Vital Signs

Guided imagery wins converts at DHMC

When a pillar of academic medicine—Dr. William Nugent, a distinguished cardiovascular surgeon—calls his discovery of guided imagery "an epiphany," people sit up and take notice. A technique that used to be on the fringes of respectability, it is gaining converts daily.

Guided imagery incorporates the power of the mind to help the body heal, maintain health, or relax. Involving a combination of touch, smell, sight, and sound, it aims to forge a balance between mind, body, and spirit. Proponents say that tapping into the mind-body connection can strengthen the immune system, reduce anxiety, ease pain, and improve sleep.

Sheila Harvey Tanzer of Hanover, N.H., has used guided imagery as a patient. "In 1993," she says, "Dr. Richard Barth removed 18 inches of my colon. The night I went home, my abdominal pain sent me right back to DHMC. Dr. Barth said adhesions had caused a small bowel obstruction. If it didn't straighten out in a week, he would have to operate again."

The next day Briane Pinkson, a DHMC nurse and massage therapist, showed up and introduced Tanzer to guided imagery. "Close your eyes," Tanzer recalls her saying. "Breathe deeply. Imagine you are half an inch tall. With a lamp in your hand, enter your intestines and walk through the twists and turns step by step. Keep going until you come out into the light. Then repeat."

Eight days later, Tanzer was wheeled in for another x-ray. Afterward, she recalls Barth reporting, "Your obstruction isn't just better. It is gone."

Improving: Nugent seems an unlikely proponent of guided imagery. The walls of his office are lined with diplomas and certificates from prestigious institutions. "About 10 years ago," he says, "I was leading teams from dozens of hospitals in a forum devoted to improving patient health care and healing. . . . Someone

Guided imagery proponent Nugent guides surgical tools here.

handed me a guided imagery CD. I listened to it that night in my hotel room. For me, it was an epiphany." The CD had been produced by Diane Tusek, B.S.N., former director of guided imagery at the Cleveland Clinic and the founder of Guided Imagery, Inc.

Today, Nugent, who is chief of cardiothoracic surgery, has Tusek's CD given to all the section's patients before surgery. Tusek recalls Nugent telling her about the day he walked into the preop area at DHMC and saw his patients wearing head - phones and the others without them. He said to himself, "All patients must have this help." Tusek says Nugent was one of the first doctors to "step out of the box."

A decade later, guided imagery is increasingly accepted in mainstream medicine.

Two studies affirming its value have been conducted at Harvard teaching hospitals. And a Blue Shield of California study found that guided imagery increased patient satisfaction and cut costs by $2,000 per patient. But the data is still soft. A senior editor at the New England Journal of Medicine admitted recently that "guided imagery is a recognized form of relaxation and pain control," though its value "is difficult to quantify in tests."

Study: Nugent, asked if he had considered conducting a study himself, replies, "I should do it, but right now surgery absorbs all my time." Tanzer reflects on her experience with guided imagery. "I still wonder about it," she says. "Something happened, I don't know what. . . . I continue to use meditation and visualization, and this daily discipline has deepened my inner peace--a gift as invaluable in good health as it is in a time of sickness."

Nardi Reeder Campion

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