This past September, on one of those perfect days where the sun is shining bright but the air has that crisp coolness to it that lets you know fall is just around the corner, I drove down the coast from San Francisco to Big Sur to attend a retreat-style meeting on creating Optimal Healing Environments. The meeting was sponsored by the Samueli Institute and the Institute of Noetic Sciences and was being held at the Esalen Center for Theory and Research.

I was very excited to have been invited to participate in this meeting. Both the Samueli and the Noetic Sciences Institutes are doing innovative and creative work on the periphery of our industry. Over the years I had heard their names mentioned from time to time, so I was familiar with them. However, I had never had any opportunity to meet with them to learn more about the direct link their work could have to The Center or to explore possible collaborations.

I was not disappointed.

The purpose of the retreat was to bring together a diverse group of people to discuss and build on an outline that had been pulled together by the Samueli Institute for a book they are writing on creating Optimal Healing Environments (OHE). For the purpose of this book, Samueli defines OHEs as having seven pillars, physical environment being only one pillar in the overall structure of their work. The others include developing a healing intention, experiencing personal wholeness, cultivating healing relationships, practicing healthy lifestyles, applying collaborative medicine, and creating healing organizations.

After reading the initial outline sent to participants before the meeting, I was impressed by the framework they had created and how expansive their definition of an optimal healing environment was. It made for an excellent framework for inquiry into how we create optimal healing environments and who needs to be a part of the conversation and process in order to achieve this lofty goal.

They pulled together a small but eclectic group of individuals for the program. I was the only person with a background in the built physical environment. Others were from the fields of nursing, social sciences, medical anthropology, cognitive psychology, clinical psychology, medicine, and sociology. All were accomplished in their respective fields, inquisitive people by nature, and all had spent their careers trying to be change agents in their specific industries.

Egos were checked at the door (along with shoes, I might add), and the discussions often went well into the night—sometimes sitting on pillows on the floor, sometimes while sitting outside on a deck overlooking the beautiful Big Sur coastline with the sounds of solo guitar music in the background. It was one of the most interesting and thought provoking meetings I have attended in a long time. Conversations often bounced around from the heights of human potentiality and the science of brain function to the more familiar (to me) topic of how to affect change on the culture of caregivers and provide them with a supportive environment to do their work, as well. Discussion would often turn to how to create the physical space that could encompass all of these ideas.

I walked away from the experience with some important insights:

  • After spending so much of my career defining environment as physical space, it was very liberating to see the physical environment as just one part of a much broader definition of environment.

  • It’s important to continue to surround yourself from time-to-time with contrarians, people from diverse fields and people who challenge your views, push you to articulate more clearly the ideas that you have come to take for granted as givens.

  • Like most people, I spend way too much time indoors. Nature is the ultimate healing environment.

On a more personal level, I have many fond memories of programs I’ve attended at Esalen over the years. I’ve always enjoyed the eclectic people I’ve met there and the overall energy the place has about it. Any time I spend there has had a transformative impact on me if for no other reason than that the time is usually so completely different from anything else I do in my life. That all might sound very Northern California, but after living here almost two decades, I am officially a Northern Californian. HD

The Center for Health Design is located in Concord, California. To comment on this article, visit


Happenings of note from The Center

  • Herman Miller has signed on as The Center’s first Corporate Research Partner.

  • The Global Health and Safety Initiative, a partnership with Kaiser Permanente and Health Care Without Harm, had a very successful launch on October 17th with more than 100 people from healthcare systems throughout the United States participating.

  • Beverly Johnson from The Institute for Healthcare Improvement was named the recipient of the 2007 Changemaker Award given by The Center’s board of directors at the recent HEALTHCARE DESIGN.07 conference in Dallas.

  • Robert Levin from Turner Construction received the first ever Russ Coile Lifetime Achievement Award given by The Center’s board of directors.



The article “Introducing EDAC,” presented in the November 2007 issue of HEALTHCARE DESIGN, contained misinformation regarding the American College of Healthcare Architects (ACHA) and the American Academy of Healthcare Interior Designers (AAHID).

The article mistakenly referred to ACHA as the American College Health Association, and described the ACHA as “strictly a membership program.” Both ACHA and AAHID have rigorous criteria that must be met before individuals become members.

We apologize for the errors and any confusion they may have caused. For more information on any of the programs listed above, please visit the following Web sites: