Creative Expression Improving the Quality of Your Life with Art, Music, Poetry, and Humor

Ernest H, Rosenbaum, M.D., Isadora R. Rosenbaum, M.A., Cynthia D. Perlis, B.A., John Fox, C.P.T., Malin Dollinger, M.D., Stu Silverstein, M.D., Jim Murdoch

“A merry heart doeth good like a medicine.” — Proverbs 17:22

Courage, hope, faith, sympathy, and love promote health and prolong life. A contented mind and a cheerful spirit is health to the body and strength to the soul. How you live has a major effect on your health and your life—not only your attitude but also your activities can promote better health. Enhancing and enriching your quality of life heightens your emotional experiences and reduces depression. Your attitude depends in part on what you expect from life and how good you think your life has been. Health depends on the interaction between mind and body and between joys and sadness, as well as having a sense of security and of being loved and appreciated.

To achieve a better quality of life, you need to involve yourself in a positive living program for the promotion of a healthy mind. The quality of life can be enhanced by the spiritual uplift and relaxation provided by interests and hobbies such as art, music, writing, and humor. These can enrich your life through positive experiences. We achieve a special satisfaction through things that we create ourselves. Becoming involved in creative activities improves feelings of self-worth, decreases depression, and promotes a sense of well-being.

The Role of the Mind in Health

Good health is one of the greatest assets we have in life, for without it our future is uncertain. The mind plays a key role in promoting good health. If your health is impaired, through an accident or illness, your life may become limited. Some of the new problems you may face will be physical, economic, social, emotional, or psychological.

Recently, there has been a shift in the philosophy of health care to a more “holistic” way of medical care, as suggested by Plato a few thousand years ago. We can’t separate the mental from the physical because they are related as part of the whole person. Being a health care provider is like being a juggler trying to balance many balls—the medical, physical, environmental, psychological, and nutritional—in an attempt to keep the heart, brain, and body healthy. Many authorities feel that 50–80 percent of illnesses are stress related, including high blood pressure, colds, depression, and certain skin diseases. Certainly, facing continued ill health can be stressful.

Research at the University of Utah evaluated the role of stress during a recent economic depression. The rate of fatal strokes and heart attacks was higher than predicted. Continuing studies are looking at how stress relates to a decrease in the function of the immune system. If a direct link is found, an immune defect could precede many diseases. There is a relationship between anger, stress, and disease. One of the secrets of good health and longevity is knowing how to control stress.  

We have known for more than two thousand years that there is a relationship between the mind, the body, and one’s health. It is an accepted fact that attitude and the will to live can, in part, determine one’s future. How one accepts and deals with adversity or controls stress and anger reflects one’s coping skills.

Norman Cousins found a way to use humor to cope with his incapacitating arthritis, fight his way back to good health, and increase his longevity. When told by doctors that his health would never improve—that he would be bedridden and either in pain or so drugged that he wouldn’t know what was going on around him—Cousins rebelled. He obtained every Marx brothers, Three Stooges, and other comedy tapes that he could lay his hands on, and watched them continuously. He found that laughing made his pain go away without the debilitating drugs. After some weeks of taking his own “cure,” he could move without pain. Then he could walk. His self-treatment is living proof that “laughter is the best medicine.”


Attitude has a major influence on our lives and has become identified as one of the important ingredients in living well and longer. Attitude is in part shaped by our experiences and education, by our failures and successes. A positive attitude can help to increase our ability to cope with life’s problems or with a disease. We have a chance each day when we get up to make this a great day for us and to achieve what we wish, or to merely accept events that occur and not try to improve our situation or to set new goals. Some things in life are more difficult to change than others. Thus, how we live is in part controlled by our attitude toward life. Because we can change our attitude, we can change our outlook, and thus our life.

The Will to Live

The will to live is nurtured by a positive attitude. A negative attitude can diminish or undermine the mind through fear, anger, or loss of self-esteem. These emotions, when unresolved, can lead to hopelessness, futility, resignation, and the loss of the will to live. (See also the article: “The Will to Live.”) Here are a few examples:

  • The phrase “frightened to death” is more than a figure of speech. An early reference to stress and fear is recorded in the Bible, in Acts 5, when Ananias and his wife Sapphira suddenly die after being castigated by Peter for withholding from the disciples some of the money paid for the sale of land. This has been attributed to a sudden coronary death from stress.
  • In primitive societies, people have been literally frightened to death by the imposition of a curse or spell, known as bone pointing. When a person who believed in the phenomenon was “boned,” he or she withdrew from the world, stopped eating, and waited to die. Death could take place in a few weeks. Such deaths have not been explained medically, even with an autopsy, but it seems apparent that the paralyzing effect of fear played an important role. The victim’s fear stems from ignorance and superstition. He has been encouraged to believe in the power of the curse. Thus, ignorance and superstition play a role in how the mind functions to help or hinder a person in living.


People with a positive attitude are able to be open—to talk about their problems with their family, friends, and physicians. They feel good about themselves and generally have been that way all their lives. It often is very hard to change lifelong patterns such as your psychological reaction to daily living.

The will to live is therefore a spiritual, emotional, and ethical commodity. It needs nurturing and developing; if controlled, it can strengthen a person’s resolve to survive. There is a direct correlation between a person’s mental and emotional states.

We measure successes and failures in life by our standards and ideals as we strive for goals in work, relationships, and health. To live just for survival makes for a shallow life. Victory is for those who have the courage and stamina to fight and endure each of life’s many struggles and who always have goals and the satisfaction of aspiring to reach them— whether they succeed or fail. This is the “challenge of life.”

We can help ourselves and others live better if we:

  • Live in the present and in the future, not in the past.
  • Set reasonable goals as to what can be accomplished.
  • Accept new problems and attempt to solve them through understanding and increased awareness.
  • Try to resolve depression and negative emotions.
  • Actively do things to help ourselves and others.
  • Learn techniques to relax and practice mind control by using simple methods to calm down, such as yoga or tai chi, or practice biofeedback or visualization.


The Role of Creating Art in Health

Authors: Cynthia D. Perlis, B.A. Ernest H. Rosenbaum, M.D. Isadora R. Rosenbaum, M.A.

A hundred years ago, it was commonly believed that people could not be creative past middle age. Now, reports Lydia Bronte in The Longevity Factor, most Americans can expect a “second middle age”—a stage of adulthood between fifty and seventy-five created by our increased longevity and good health. Today, people in middle age and beyond sometimes feel that life is just beginning. A new sense of identity is discovered and defined along with an enhanced sense of self. During these years, art can be a healing force.

Artistic expression is an important psychosocial activity. We can create art by ourselves or we can attend classes ranging from beginning drawing to advanced printmaking. Sometimes we can express ourselves visually when we are unable to express ourselves verbally. Art can help us express what we are feeling in the present, yet it also can help us to express a memory, a moment that has happened that we do not want to forget. Music, drawing, painting, and creating sculpture provide a means of communication and self-expression— and a way to alleviate stress. Art also helps us to change our moods, come out of depression, or simply relax.

Art can be richly therapeutic for people, including the elderly, with a serious illness such as cancer. Suzanne, a woman approaching eighty who is living a full and energetic life in spite of her advanced cancer, has continued to teach art classes, take printmaking classes, and work in her home studio. Her recent works have included drawings and watercolors that express what it feels like to cope with life-threatening illness. She has created drawings that tell the story of her disease. One watercolor, The Cell of Positive Thinking, was created when she began a course of chemotherapy.

Creating art, says Suzanne, improves her self-worth and leaves a permanent gift to be enjoyed by all. She has received constant encouragement and support from her friends and family. They drive her to art classes and create along with her. Together they are participating in a shared experience, a shared community of meaning; the essence of what it means to be human. You do not have to have artistic ability to be creative. Sometimes, just doodling or experimenting with art materials can open up a wide range of ideas. People often become too critical of their work—or are afraid others will judge their ability. It is important to express yourself for yourself and not for other people’s approval. There really is no right or wrong in expressing who you are. For instance, if you feel you cannot draw, try making collages from pictures cut from magazines.

Creating art at any age gives people an opportunity to express what they are feeling. Creating art provides the ability to make decisions for oneself. With the opportunity to make decisions and to exercise control over choice, people enhance their quality of life, improve self-esteem, and create ways to relate to others in a meaningful way.

A whole life or one experience can be shared in a work of art. One artist writes, “No, I will never say my work is finished. I must live forever—on and on. The reason we artists enjoy such longevity is that we are always looking ahead to the ‘masterpiece’ to come.”

Here are some recommended creative art activities:

  • Draw a self-portrait. Include words to describe who you are.
  • Create a family tree—ask family members to draw their own portraits on the tree.
  • Take painting, drawing, or sculpture classes at your local community college. If you feel you’re not good enough, take a beginners’ class—everyone will be in the same boat.
  • Draw your dreams.
  • Make a collage with pictures cut out of magazines. Decide on a theme before you start or let the theme evolve.
  • Do a drawing with a friend, child, grandchild, or spouse.
  • Take photographs.
  • Learn needlepoint, quilting, crocheting, tatting (lace making), or knitting.
  • Buy fabric paint and paint on T-shirts.


Don’t be judgmental—there is no right or wrong, no rules, no grades. Smile as you create. Share with others. Be encouraging to yourself and others. Enjoy!

Breast Cancer Quilts

Authors: Cynthia D. Perlis, B.A. Ernest H. Rosenbaum, M.D. Isadora R. Rosenbaum, M.A.

Inspired by the AIDS quilt, in 1996 a project was suggested to the Susan G. Komen Foundation that was designed to give women with breast cancer a creative voice. Because the tradition of quilt making has been nurturing and creative for countless women throughout history and, as it had for people with AIDS, could serve to bring the terrible epidemic of breast cancer before the public in a moving and beautiful way, Dr. Rosenbaum suggested that women who had had breast cancer touch their lives create their own quilt.

Cynthia Perlis, director of Art for Recovery, remembered the touching stories and drawings that women with breast cancer had shared with her. It was time to give these women a voice in the larger community, to let them speak through their creative spirits and to share their pain, their hopes, and their dreams along with their families’ and friends’ visions and wishes. Women recovering from and coping with breast cancer would be able to express visually their feelings about this illness. The Breast Cancer Quilts Project became a project of Art for Recovery through quilt workshops and meetings with women at their bedsides.

These squares began to represent the entire scope of this devastating illness. One square read: “I WON THE LOTTERY NO ONE CARED TO ENTER.” On another piece of fabric, written in ballpoint pen, was the entire story of one woman’s breast cancer experience. Another woman embroidered “THE GIFT OF A LIFETIME” and dedicated the square to her doctor. The quilt makers then sewed the squares into a beautiful quilt.

One year later, there were five quilts, each measuring eight feet by eight feet, and each including images by twenty-five women with breast cancer or in memory of a loved one. Now, in the year 2005, there are fifty quilts, and the number is growing by five quilts a year. The quilts have been on display across the country. One of the most poignant parts of this project are the stories that women have written about their own squares that tell the painful reality of breast cancer. Here is one example:

I wanted to make this square as a thank you to my three daughters who have been so loving and supportive these past ten months. The design idea came from a beautiful Christmas tree ornament given to me by my second daughter. I was extremely touched by this gift and displayed it prominently on our tree.

I didn’t really understand why it made such an impact on me and I’m not sure I know the answer yet. However, I suspect one of the reasons was that it was possible to have something beautiful represent a difficult and challenging time in my life. It also served as a daily reminder to be ever vigilant and to never forget. I wear a pink ribbon of some kind every day now to continue to remind myself, my daughters, and the world that the ENEMY is still out there ready to strike 180,000 more women this year alone.
—Elisa Bambi Schwartz

The Breast Cancer Quilts Project continues to invite women from around the country to create images for the quilts. In May 1998, eleven quilts were exhibited at the National Institutes of Health as part of the National Cancer Institute’s Breast Cancer Think Tank to support women battling cancer and increase public awareness of the disease. As a result of this prestigious exhibition, calls continue coming to Art for Recovery from all over the United States wanting information about participating in this significant project.

The Role of Poetry and Prose in Health

Authors: Ernest H. Rosenbaum, M.D. Isadora R. Rosenbaum, M.A.

Poster Girl

I want to be the poster girl
For this cancer that has invaded me I want the doctors (after treatments) To say, “There’s no cancer I can see.”
How did this cancer get inside of me? I did not invite it here
And since it is not welcome Why should I fear it?
It’s true that it is awesome But my God is awesomer. So, cancer, you got to go As I’m sure you must know
Do you think that I saved this body For a poison such as you?
Do you think that I will lay down And accept you as my due?
Not ’til I’ve declared war And fought my very best
I won’t let up until I’ve destroyed you You most unwelcome pest
—Josie Teal, July 2000

Since the development of written language, humans have tried to capture their lives and history through writing. The ancients used pictures and signs to record their lives and thoughts. Over the centuries, this has evolved into written history as well as literature. Like art and music, literature—whether prose or poetry—is another way to support and enhance patient care and well-being. Like art and music, literature can be “the best medicine” and, through the benefits of self-expression, can have healing powers.

Reading or writing poetry or prose can reduce boredom and help relieve depression. It can divert your mind from your medical situation, provide creative stimulation, and help you to communicate your feelings with your family, friends, and medical team. Enjoying the use of your creative spirit and intelligence can provide a vital force to improve your state of wellness, daily living, and quality of life.

You may feel unsure about your ability to create literature, but do not be too critical of your early efforts because it takes time to learn techniques and to discover your unique “voice.” Your talent will develop if you give yourself a chance. Many people find that taking a creative writing class or joining a poetry or fiction writers’ group provides guidance and reduces their initial frustrations.

When people are seriously ill or depressed, they often feel hopeless. Receiving bad news about their disease or treatment can heighten such feelings. Even during the recovery process, people may feel sadness and a heaviness of heart. Reading great literature, whether prose or poetry, as well as attempting to express your own feelings of sorrow and loss through writing can raise your spirits, provide relaxation, and give creative satisfaction. Working with others in a class or group also can help to prevent isolation.

A patient who is a poet described the deep effect that reading Pushkin, Lermontov, and Pasternak has on her heart and spirit. She also said, “Sometimes when I have had a sad or hard day, I create poetry myself. Poetry makes my heart ‘burn bright’ through its magical strength. It also pleases me with an unusual inner feeling when people read my poetry, which for me is a ‘lyric confession.’ They appreciate my lyric confession when they understand my point of view and this creates an impulse to create more and more poetry.”

This poet is also a journalist and writes articles and reviews on art, dance, and music. She says, “I have also enjoyed the recognition I have received. It has led to important moments in my life during the past two and a half years, such as when a small, four-page newspaper, Odessky Listok, reprinted stories [I had written] of people from other cities and countries. Readers appreciated the stories about people’s adventures and lives, which is not only a personal declaration of their importance on earth but for mankind as well.”

“I want to live—to think and suffer”
The poet said, and I agree.
I want to live to sing in poems
The taste of life, its smell, its joy, its dreams.
I want to share my deepest feelings
How free and happy—I am blessed to live
In Golden State—unique and gorgeous
In the mysterious Bay waves.
I want to suffer, but not from pain
Not from the evil—my inevitable fate
I want to cry from love, to love again,
Be loved, forget my age, be able to create.
—Tamara Belorusets, translation by Yelena Nechay

Alexander Morrison, also a poet, said, “I also have written poetry for many years. I find it interesting to observe how, in different ways, I expressed the same philosophy at eighteen as I do now. I was amazed then, as I am now, at how the human being, screwed by circumstances beyond all belief, can manage to stand up despite the un-mitigating bullshit that presses down on him. I’m talking about mankind and people like myself—the survivors and the contributors, the people I think have become successful human beings.”

Trace the affinity
Of the will to be
With the ability
To Be no longer.
Ah . . . such a narrow way divides.
And yet, in the precarious clime
Of this most eccentric inch
A world of men lived Triumphant!
—Alexander Morrison

“I’m looking for the same answers I looked for at eighteen. I haven’t changed, but I do know that even with the odds tremendously against you, most of us manage somehow to make it.”

The vulgar splendor of a noise
Contents the appetite of ears
Insensitive to subtleties
The really loud occurrence falls
Without the benefit of sound
How silently are these:
The awakening to love,
The audacity to dream,
The will to live.
—Alexander Morrison

The Recovery

No longer can I bear
To dwell in this misbegotten state
Of involuntary confinement
The sorrow is too deep
The truth of it too great
For human comprehension
And so, with anxious hands I break away
The larval crust and shake myself free!
Outside carillon bells
Sing of my resurrection and celebrate
My reawakening with soft murmurs
Bird songs and forgotten lullabies
They call to me, beckon me
Into the blazing light of day
And direct me toward the path
Of undisturbed freedom!
With grateful tears
I squint into the blinding sun
And with an innocence of childhood born
I join the living once again
All is forgotten
—Diane Behar

My breast, my womanhood, my life.
These things I took for granted.
But that all changed just
as the New Year began.
No, it couldn’t be happening—not to me.
It just doesn’t happen so fast.
I was just checked.
It doesn’t run in my family.
It’s just my imagination.
It’s probably nothing.
Or is it?
It’s a Saturday night.
How long should I wait?
Then Monday came.
My doctor’s on vacation.
Find someone else, I can’t wait.
“Just a cyst,” they said,
“This doesn’t look good.” “What does that mean?” I said.
“Don’t worry, it’s probably nothing, but get it checked IMMEDIATELY.”
“Don’t panic,” they said, as if I could stop.
It’s all so unreal,
like I’m in a padded tunnel.
More tests, more worried looks, no answers.
“See a surgeon,” they said, “ASAP.”
I felt so alone, so small, so scared.
Why me? Will I die? Will I be mutilated?
Will Chris still want me?
“We’ll call you tomorrow, just relax.”
As if I could!
Who are they kidding?
Somehow I slept that night.
I can’t remember what I dreamed.
It’s probably better that way.
We met the surgeon the next morning;
I vaguely remember.
“I’ll have to operate,” he said.
“Go home, wait for the results.”
The hours seemed endless.
Then the call came.
Oh, God! It can’t be true!!
Not cancer! Not me!
I nearly collapsed.
Chris looked so helpless.
My life flashed before me.
Not so much the past,
but the future I was so scared of losing.
I’m too young to die.
I’m not finished living.
So back to the surgeon we went.
“It’s a nasty one,” he said.
“We’ll operate tomorrow,
no time to wait.”
What will I look like?
How much will they take?
Has it spread?
Will it come back?
Will my life ever be the same?
—Holly Kurzman, 1999

Poetic Medicine: Using Poetry to Deepen Your Connection to Self and Others

Author: John Fox, C.P.T.

We human beings are at our best when we enjoy poetry. Sometimes all you need is to reflect in your mind one poem that says, “I can make it through.” Maya Angelou

Support is a major issue when coping with cancer or any illness that requires intense medical intervention and time. The sheer logistical requirements of doctor visits and hospital treatments can be exhausting! Indeed, it can be difficult when you are ill to make it through a day without the help of a friend or family member acting as advocate and companion, the support of a medical professional offering treatment, or the help of a counselor or minister. Support may come in the form of stress-relieving practical information, advocacy, friendship, and counsel; but there is a particular kind of support that offers nourishment to your creative spark. This creative spark is accessible to us even when we are ill. We may experience a pull toward imaginative expression as a form of healing, but when dealing with the necessities of illness, your creative voice may be given short shrift.

The previous box spoke of the role of poetry and prose in health. The encouragement to write down your feelings will nourish your creativity. How can you get even more out of your creative expression and the healing art of poem making?

Giving attention to this creative spark may support your desire to live life as fully as possible. People find that the expression of feelings, images, and metaphor meets some of their deepest needs in being human while coping with cancer and, at the same time, taps into their spiritual strength, playfulness, and search for meaning. Creative expression helps you hold on to your core self while facing the demands of a disease like cancer. Poetry reminds you that you are more than a disease.

How can you get started? You can start by putting your pen to the page! You don’t have to share your writing with anyone; however, you might find it a surprising source of inspiration and support when you do so.

Ask a receptive friend (perhaps a few friends) or a family member with whom you are comfortable to share in the writing and reading of poems. Ask someone to share their favorite poem with you. Robert Pinsky, former Poet Laureate of the United States, appears regularly on the News Hour to share Americans’ favorite poems.

You could ask a nurse, caregiver, or doctor if they are open to listening to your poems, and perhaps to share their own. There is a growing interest among nurses and doctors in poetry. Medical humanities courses are increasingly popular at medical schools. Poems regularly appear in the Journal of the American Medical Association. You can encourage this healthy trend!

The opportunity to share poems, to speak poems you’ve written, and to listen to others read their poems can deepen your connection with what matters to you. There is a spiritual dimension to this creative bond that allows for a deep and vulnerable place in a person to be received and honored. This is sharing at a level that fosters honesty and compassion.

Your poetry can explore joy and grief, insight and confusion, pain and pleasure, fear and love, what you do and do not know, your enjoyment of the natural world, and your intuitive awareness. Spirit poems that speak to these things feed the bonds of relationship and the soul of each person. Laura is a close friend of Kathy, a woman with ovarian cancer. Laura accompanied Kathy through many aspects of her illness and treatment. They formed a special bond by sharing poems together.

When, because of her illness, Kathy had to leave a writing group she had joined with Laura, she continued to meet with Laura to share the writing and reading of poems. Laura says of their experience, “Having the chance to work on poetry together brings Kathy back from getting lost in the medical reality. I know it is a return to wholeness for her and it helps me to see her wholeness too. To be with someone coping with serious illness can at times be heavy and stressful, but because we are sharing with one another in this creative way, there is a deepening of our friendship that is nourished by poetry. Poetry keeps us receptive to moments of joy, connection, and compassion. Writing makes us aware of a place that holds a deeper meaning than the medical reality. It carves out a time and a space where the illness is not totally in control. Listening to the voice of poetry is liberating. It’s a chance for both of us to be ourselves.”

It is important to establish a safe environment when exploring healing issues through writing. Trust and empathy, openness and honesty, playfulness and respect— these are threads that weave the fabric of relationship. These qualities become more crucial in a relationship when we are ill.

Nurturing these qualities will be helpful in drawing out creative expression when, under the pressure of illness, our safety is threatened. Illness forces us to enter the unknown, a loss of identity for instance, that can be frightening. Poetry can be a companion for this difficult journey and offer a way to navigate in the darkness.

Kathy comments about her writing and sharing poems, “Writing poems helps me to remember who I am. What I love. The writing brings me to life again. It brings back my love of creating things I enjoyed before I got sick. I feel so much more of my value and worth—both in writing and sharing. There is something about writing that sometimes has nothing to do with illness. The following poem came to me after waking from a dream.

The Spring of Inner Joy

Around the spring of inner joy
We gathered, just we three
Father, Son & Holy Ghost
and their invisible me.
Out amongst the pines at night
We heard the owl call
“Strengthen, Deepen, Darken, Flyers.
I will fly for all.”
And but for their abundant joy,
A gift beyond us all
We fed together in the night
All those who heard the call.

“This is a mysterious poem for me. It is a celebration. I think the ‘invisible me’ is a part of myself that came back to me in writing the poem. This poem is very promising. Like an underground seed, this poem is a truth I am not quite aware of.

“My sister begged me for a copy of this poem, as did my friend Jan, who said it spoke to her about her own spirituality. I was so pleased that my poem was deeply meaningful to them! That meant a lot to me.

“Laura just bought me a new blank journal and I love it. The cover is wine-colored— magenta and a couple of shades of blue. It is very personal, especially when you can also include drawings. I love the colors; I want to hug it. It’s perfect for me.”

The benefit of people supporting one another’s creative voice is profound, especially when we are exploring the unknown that we all face.

Art for Recovery/Firefly Project

Cynthia D. Perlis, B.A.

In 1992, I developed the Art for Recovery/ Firefly Project for patients to enjoy the art of writing letters to teenage pen pals. The idea developed from my Art for Recovery program hospital visits, where I noted that although these people in many cases were quite frail, weak, and in pain, their spirits were very much alive. I felt that they had much to offer in the way of personal experiences, insight, and wisdom.

Seriously ill patients could become, in effect, teachers. During the first year of this program, I matched twelve patients, half with cancer and half with AIDS, with twenty-four seventh and eighth-grade students (aged twelve, thirteen, and fourteen). The teens wrote letters to the patients, including drawings if they chose to do so. They could ask absolutely any question, such as, “Are you afraid to die?” “How did you ever tell your parents that you had cancer?” One twelve-year-old girl wrote to a thirty-two-year-old woman with leukemia, “How did you ever tell your parents you had cancer? I could never tell that to my parents.” The patients would respond by writing about their jobs, their families, and their illnesses. They would answer the teens’ questions about their conditions and difficulties and tell them about all their experiences.

The students and the patients exchanged letters for nine months. To date, more than five hundred students and as many patients have built bridges and have created their own community. Fifty patients have died, some during the school year. At the end of each school year, there is a healing service, where the students and the patients meet face-to-face for the first time. The students read aloud blessings that they have written and the patients bring the students symbols of healing. This experience defines the true meaning of the word “mitzvah” (a Jewish word for a good deed). A performance piece is performed (script in hand) with the patients and students as actors.

The following letters are excerpted from the correspondence between a woman with breast cancer and a second with leukemia and their twelve-year-old pen pals.

Dear Katharine,

How did you know you had cancer? My sister has a muscular disease, so I know about muscular problems, but I don’t really know anyone with a serious disease. Was it really scary when you found out you were ill? How long have you had cancer?

I’m really looking forward to writing you.
P.S. Please send a picture.

Dear Lily,
It was really nice to get your letter.
I have breast cancer and I found a lump in my breast that felt big and hard. I could also feel swollen lymph nodes under my arm. It was very scary when I first found out.

I had to go through a lot of treatment and make decisions about the treatment. That was hard. I seem to be doing well so far and hope it continues this way.

Because I am a physician, I see a lot of children with serious diseases and also a lot of children who are healthy. I’m sorry to hear that your sister has a muscular disease. How has it been for you to deal with this and help her?

Thank you for your very nice picture—
Write soon.

Dear Emily,
I got some bad news recently. My leukemia is back. The doctors are very surprised; it is unusual for someone who has done well for two years to get their cancer back now. I always knew there would be a chance for it to come back, but I was hoping it would be longer (or not at all).

I had thought there was nothing more the doctors could do. But they want to try a procedure on me where they get some cells from the man who donated some of his bone marrow to me before. These cells are white blood cells and they fight off infections. The doctors hope by giving me these cells, it will help boost my immune system to fight off and maybe destroy the leukemia.

It is a hard decision for me to make. It might be hard to understand why I might decide to just let the leukemia kill me. The procedure will make me pretty sick again. And the doctors are not too sure it will work anyway. I was not very happy last time I was in the hospital and I am not looking forward to being sick again.

But my friends and family seem to really want me to try this procedure because it is my only chance to live.

It is hard to realize that I have to make these kinds of decisions. I am just a regular, normal person. These kinds of things happen in the movies or on TV.

Whatever happens, I would like to keep writing you. We can write about all sorts of things still. And you can ask me questions about what is happening to me if you want. The leukemia is part of my life, but not all of it.

My knees are better; I almost walk normal. But I am still pretty weak. Only my left leg can go up the stairs. It is like someone is holding me back if I try with my right leg.

Dear Jana,
I am very sad right now because you have got leukemia again. I had no idea this could happen again and I am very sorry. But I have a lot of hope that you will get better and I know you will too.

When did the leukemia come back? Is it as bad as it was before? How does your family feel about this? Are you afraid? How do you feel about coming back to the
hospital after you’ve been out of it for so long? I have so many questions about this. I heard from Cindy that you feel okay right now and I’m really glad about that. I hope that the new procedure the doctors are going to try will work.

It really is going to be a hard decision for you to make, but I think that if I were in this same situation, I would just try whatever the doctors think might work. I don’t know why, but I hope whatever they do works and I hope you’ll feel better soon. I would like to keep writing to you too.
Thanks for saying I can ask questions about what is happening. . . . I’m glad your knees are better.

Currently the Firefly Project is expanding, including high school students as well as middle school students. In addition, a “how to” manual will be written this year so that this project can be replicated across the United States. The performance (a script created from the actual letters) continues for the third year, with a community audience of over three hundred. As a result of the student participants in the Firefly Project, Art for Recovery Clubs are being formed in local high schools.

The Role of Humor in Health

Ernest H. Rosenbaum, M.D. Malin Dollinger, M.D. Stu Silverstein, M.D.

Humor and laughter have been found to have a positive effect on the body’s physiology and to induce relaxation. They help people cope and produce improved relations among family members and friends. A lighthearted attitude can reduce the chance of illness, reduce depression, and thereby promote longevity.

Humor reduces stress almost immediately. It also helps alleviate pain. Laughter has even been used as an aide in treating disease. As Norman Cousins stated, “I made the joyous discovery that ten minutes of genuine belly laughter had an anesthetic effect and would give me at least two hours of pain-free sleep.” He discovered that watching funny movies with the Marx Brothers or the Three Stooges was therapeutic. Cousins wrote in Anatomy of an Illness that he deliberately tried to increase his laughter to help improve his health.

There is an old joke that a man was wondering what the meaning of life was, and he became morbidly depressed over this question. He even tried to shoot himself in the head, but missed. Finally, in desperation, he wandered randomly into a movie theater, where a Marx Brothers movie was showing. There he realized that as long as there is laughter, there is meaning to life.

Thus, humor can do wonders to help lift the spirits. Some studies have shown that if you just smile, the body has a positive response. Try it and see what happens.

The Physiology of Humor and Laughter

Humor usually results in laughter, which arouses the emotions, resulting in physical changes. These include short-term increases in blood pressure, heart rate, and respiratory rate, and reduction of stress.

Laughter stimulates the brain to produce endorphins (morphine-like relaxants that have a euphoric or analgesic effect). The result is muscle relaxation, an improvement in mental and spiritual well-being, and often a decrease in hostility and anger. Laughter also confers several long-lasting benefits on your body; it lowers blood pressure and it also serves as a mini-aerobic workout. Scientific studies are looking at exactly how laughter, joy, and a humorous perspective can have a positive effect on health and improve quality of life.

Laughter from jokes, speeches, comedies, plays, movies, operas, or other humorous events is a socially accepted way of getting a message across. It is sometimes a means of getting through personal tragedy or crisis (for those creating the humor as well as for those responding to it). Some people find that telling jokes about themselves removes some of the heaviness they may feel about their lives.

Humor can be spontaneous or specifically created, but no matter how it comes about, it can make a difference to your life. It has healing power for both body and soul as well as helping to sustain one self through some of the depressing episodes of life.

Benefits of Humor

There are many benefits of humor. Here are some of them:

  1. Humor can help us expand our perspective on life and enhance creativity.
  2. The more we laugh, the better our chance of decreasing depression and promoting the healing process. Promoting the laughter factor injects more happiness into daily life.
  3. Humor can improve family relations and smooth communications.
  4. Humor provides physical and mental energy and rejuvenation through emotional relaxation.
  5. Humor helps people cooperate and communicate, and decreases anger and fear.
  6. Humor can promote a will to live, manufacture energy, improve self-esteem, and increase one’s sense of self-worth.
  7. Humor is considered by many to be one of the great medicines of all time.
  8. Humor can reduce anxiety and thereby improve the enjoyment of social experiences such as dining.

There is an old Dutch saying that humor often comes from telling a tragic story after enough time has passed. In this way you can laugh at many hard times in your life. It wasn’t funny at the time, but after you triumph over the tribulations of life, the stories can later be uproariously funny.

How to make humor work for you:

  1. Collect or write down humorous anecdotes, memories, cartoons, and jokes. Refer to them often to improve your emotional energy and revive sagging spirits.
  2. Create humorous cards and cartoons to make you laugh every day. Often, telling personal or family stories about life is a way of sharing humor and funny events.
  3. Take a class on writing or telling jokes.
  4. Keep humorous books, articles, or cartoons nearby. Refer to them frequently to make yourself smile and laugh.
  5. Try to avoid frequent contact with depressing people who drain your emotional energy. Associate with positive people who use humor.
  6. Promote parties and fun social events, such as birthdays. You need to make them happen.
  7. Arrange a get-together with friends or relatives to tell jokes, recall happy and funny events, or share a funny video or movie.
  8. Regularly visit a local comedy club.
  9. Maintain a compendium of humor and philosophy to help you reduce isolation, anger, despair, or loneliness.

By using vignettes, jokes, or philosophical or practical sayings or words, you can improve your coping skills and reduce despair. A bit of humor, when appropriate, can make a sad event a little lighter and more positive. For grave or serious situations, a little humor can decrease your level of unhappiness. Apply the techniques of Norman Cousins.

Don’t leave it to chance. Actively seek humor in your life. Those who laugh last laugh best!

The Role of Music in Health

Authors: Ernest H. Rosenbaum, M.D. Jim Murdoch
Isadora R. Rosenbaum, M.A. Malin Dollinger, M.D.

Music has healing powers. It has been said that music soothes the savage breast. Plato believed that health in body and mind is obtained through music. Florence Nightingale used the healing powers of music as part of nursing the ill. Music affects the physiological and psychological aspects of an illness or disability. In the Bible, David, the shepherd boy, played his harp to help the psychologically anxious, insomniac King Saul relax and sleep. And music was used to calm shell-shocked soldiers in World War II.

Music has a personal meaning to each of us, often recalling or eliciting a positive emotional response. It has a universal appeal, it is inexpensive, and it crosses cultural barriers. It is available by Internet, radio, TV, tape player, CD player, vinyl records, and live. It can be listened to quietly, through earphones, or out loud for all to enjoy.

There always is a place for music in our daily lives. It gives a special pleasure and enjoyment and improves our mood. It affords us a way of expressing ourselves in a nonverbal way that can give us joy, calm us down, or lead to great excitement. It can provide us an escape or reach down into our deeper soul and elicit emotions that are pent up. For some people and their relatives and friends, music offers a special way to pass time that may sometimes seem endless.

Music can provide a way to decrease stress, promote emotional recovery, and provide relaxation. It also can afford a means of communication without the need to use a common spoken language.

Physiological and Psychological Effects

Music can increase or decrease heart rate and blood pressure, depending on the tempo and type of music. It can relax and reduce anxiety, or it can stimulate and heighten awareness. The intense emotions evoked by music can affect the nervous system and induce production of endorphins (natural painkillers). Music can help relax muscles to decrease nervous tension. It also can reduce alienation and feelings of isolation, and improve self-control and confidence.

Both age and illness and its therapies can affect a person’s psychological equilibrium, causing depression as well as negatively affecting spiritual and emotional feelings and social interactions. Music offers a bridge in helping to support a person through many of the crises in life. It reduces stress and thus reduces stress-related illnesses.

Emotional Enhancement

There is a type of music to fit any emotion or mood. John Philip Sousa playing the “Stars and Stripes Forever” brings cheers and elicits patriotism. Verdi’s Requiem or Rossini’s William Tell may elevate the mood and give waves of relaxation to reduce stress or help alleviate grief. Listening to Mendelssohn’s A Midsummer Night’s Dream, or a Count Basie or Turk Murphy jazz program, can provide an emotional lift. Listening to the soft sentimental music of Nat King Cole, Glenn Miller, or Tommy Dorsey is relaxing; it also can provide fun and exercise if you get up and dance.

Music offers immediate gratification. You can sit and tap your feet to the rhythm, play simple instruments, or stand up and march. You can hum a tune to yourself or sing it out, but you also can sing songs, clap your hands, or even sing in the shower. Pretend for a moment that no one else is around. Think of your favorite song, the one that brings back pleasant memories— especially of someone close to you. How do you feel now? Do you understand how powerful music can be in helping us gain emotional peace and happiness? Music is a form of communication that can be enjoyed with others. It requires no active participation, unless you wish it to.


A music program:

  • reduces boredom and disillusionment;
  • creates and enhances a happy mood;
  • recalls pleasant experiences, bringing pleasure;
  • offers immediate gratification;
  • creates distraction from problems of daily living;
  • may improve bonding among family and friends; and
  • leads to an opening up of communication as people reminisce after enjoying music together.

In the hospital or treatment setting, music:

  • helps improve coordination when used with physical therapy rehabilitation;
  • gives psychological, social, physical, emotional, and supportive benefits;
  • enhances—through rhythm—the effectiveness of speech training in persons who have had brain damage; and
  • helps reduce anxiety commonly seen during medical therapy, thereby making therapy more acceptable.

Music is truly a vital part of our lives— when we are well and especially when we are ill. We can see the positive benefits live music can have for hospital patients and their friends and families from their reactions to a musician playing for them in their rooms.


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Patient Stories


Ernest H. Rosenbaum, M.D.

Clinical Professor of Medicine, University of California, San Francisco, Comprehensive Cancer Center; Adjunct Clinical Professor, Department of Medicine, Stanford University Medical Center; Director, Stanford Cancer Supportive Care Programs National/International, Stanford Complementary Medicine Clinic, Stanford University Medical Center, Stanford, California. More 

Ernest H. Rosenbaum’s career has included a fellowship at the Blood Research Laboratory of Tufts University School of Medicine (New England Center Hospital) and MIT. He teaches at the University of California, San Francisco, Comprehensive Cancer Center, was the cofounder of the Northern California Academy of Clinical Oncology, and founded the Better Health Foundation and the Cancer Supportive Care Program at the Stanford Complementary Medicine Clinic, Stanford University Medical Center.

His passionate interest in clinical research and developing ways to improve patient care and communication with patients and colleagues has resulted in over fifty articles on cancer and hematology in various medical journals. He has also participated in many radio and television programs and frequently lectures to medical and public groups.

He has written numerous books, including Living with Cancer: A Home Care Training Program for Cancer Patients; Decisions for Life: You Can Live Ten Years Longer with Better Health; Cancer Supportive Care: A Comprehensive Guide for Cancer Patients and Their Families; Nutrition for the Cancer Patient; Everyone’s Guide to Cancer Therapy; and Everyone’s Guide to Cancer Survivorship. For Everyone’s Guide to Cancer Therapy, Ernest Rosenbaum, M.D., Malin Dollinger, M.D., and Greg Cable received and Honorable Mention in 1991 from the American Medical Writers Association for Excellence in Medical Publications. Ernest and Isadora Rosenbaum received the same award in 1982 for their book, A Comprehensive Guide for Cancer Patients and Their Families.


Isadora Rosenbaum, M.A.

Isadora Rosenbaum is a medical assistant who worked in immunology research and is currently at an oncology practice at the UCSF Comprehensive Cancer Center offering advice and psychosocial support. She coauthored Nutrition for the Cancer Patient and The Comprehensive Guide for Cancer Patients and Their Families. She has written chapters in Everyone’s Guide to Cancer Therapy, Living with Cancer, and You Can Live 10 Years Longer with Better Health.

Cynthia Perlis, B.A.

Director, Art for Recovery, UCSF Comprehensive Cancer Center; Director, the Lorna Barati Music Program, Mount Zion Health Systems, Inc., San Francisco, CA

Malin Dollinger, M.D.

Clinical Professor of Medicine, University of Southern California, Los Angeles.

Malin R. Dollinger’s lifelong dedication to the field of oncology and patient education has included a patient care and research position at the Memorial Sloan-Kettering Cancer Center in New York and a post as Director of Oncology at Harbor General Hospital/UCLA Medical Center in Los Angeles.  More He has been in the private practice of cancer medicine (medical oncology) for over thirty years. He is the author of over 100 articles and book chapters, has contributed to a number of books about cancer, and is a member of the peer-review editorial advisory boards of the Medical Letter (New York), of the Annals of Internal Medicine, and for the American Cancer Society.

He is a consultant to various scientific and medical organizations and now conducts a medical oncology practice devoted to second opinions for cancer patients ( He teaches at the University of Southern California School of Medicine, has lectured extensively to medical professionals and the public, and has helped to educate the public about cancer in radio and TV appearances. He served as Vice President of Medical Affairs at the John Wayne Cancer Institute in Santa Monica, California, and was President of the local branch of the American Cancer Society, where he won awards for his public education programs. Additional training and experience have been in the fields of medical quality assurance, risk assessment, and managed care. He is especially interested in improving communication with cancer patients and their families and in the emotional issues associated with cancer.


John Fox

John Fox is a Certified Poetry Therapist, is a poet and author of Finding What You Didn't Lose:  Expressing Your Truth and Creativity through Poem-Making and Poetic Medicine: The Healing Art of Poem-Making. He teaches regularly at the collegiate and post graduate level.

Stu Silverstein, MD

Stu Silverstein, In addition to being a Pediatrician--is also an award winning standup comedian and keynote speaker.  

Jim Murdoch

Art for Recovery, UCSF Comprehensive Cancer Center, and the Lorna Barati Music for Recovery Program, Mount Zion Health Systems, Inc., San Francisco, CA