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The Australian artist John Olsen asked a 6-year-old boy what he was drawing and was thrilled by the answer, ‘I'm drawing my think.’ Psychoanalysts give young child patients drawing materials and try to interpret the material in the children's drawings. Sometimes you don't need to be a psychoanalyst. As a medical student, I worked as a volunteer in a children's home. A little girl there showed me a calendar she had made and the month of December had every day marked except 25 December. Christmas Day is not a joyful prospect for a child from a children's home. A social worker of my acquaintance who works with disadvantaged children always takes coloured pencils and paper on her home visits and lets the children draw whatever they like. The results are often poignant, as the children reveal their sadness or their anger or their happiness in their drawings.

Art in children's hospitals can take the form of artworks created by child patients to help them express their creativity. There is every possibility that creating artworks would be therapeutic for children in hospital, particularly children with chronic or terminal conditions, allowing them to express emotions that might otherwise be sublimated. Art in hospitals can also benefit the staff, patients and visitors, to improve the environment. In this issue of the Journal, Joanna Capon describes the remarkable art collection at the Children's Hospital at Westmead, which uses no money from the health budget, which owes so much to her energy and tenacity, and which brightens the lives of all the patients, their families and visitors and all who work in the hospital. In addition, she describes her highly successful Operation Art project to get schoolchildren making artworks.1

Adolescents who need to be in hospital often have chronic debilitating and sometimes life-threatening conditions. In the 1990s, University of New South Wales art students collaborated with adolescent patients at the Children's Hospital at Westmead to help them make artworks from recycled hospital equipment in a project with the ambiguous name Art Injection.2 The resulting artworks were beautiful and often very confronting. A boy with hydrocephalus who needed multiple revisions of his ventricular shunt made a fearsome sculpture from a drip-stand of a metallic man with tubes containing red and blue liquids running from head to toe (Fig. 1). Two girls with anorexia nervosa made sculptures that were used to illustrate an article on anorexia nervosa.3 A child with short stature made a sculpture of a white-coated doctor on ‘stilts’ made from crutches (Fig. 2). Many of our staff could not bear to visit the exhibition. Sadly, obtaining continued funding is often a problem for such innovative enterprises.

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Figure 1. ‘Nil by mouth’ by an adolescent with multiple shunts for hydrocephalus.

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Figure 2. ‘The doctor’ by an adolescent with short stature.

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In the USA, there are some inspiring art initiatives which illustrate that obtaining ongoing funding is not impossible and persistence can sometimes be rewarded. The Oakland Children's Hospital has had an artist-in-residence since 2008 (http://www.childrenshospitaloakland.org/child_life/artistinresidence.asp) and relies on donated funds to maintain this position. Even more remarkably, Georgetown University Medical Center has had a multicultural paediatric artist-in-residence program called Studio G since 1993.4 It was started with a grant from a philanthropic foundation and continues with funding from other foundations, from staff and from private donations. Studio G uses a full range of professional artists (poets, dancers, musicians, visual artists, puppeteers and storytellers) to help children and their families cope with stress related to illness and hospitalisation. Children unable to join in the group activities are visited in their rooms.

Finally, art can be humorous and it is a truism that humour is the best medicine. Many of the artworks in the Children's Hospital at Westmead illustrate the artists' sense of humour. Children's works can make you smile (Fig. 3). There can be few more attractive works than the stripy socks arranged as chromosomes made for Guy's Hospital, London by Gina Glover (see Figure 4 and http://www.ginaglover.com and http://www.artinhospitals.com).

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Figure 3. ‘Ellee eating lunch’ by Ellee Munro (from Operation Art).

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Figure 4. ‘Chromosomal stripy socks’ by Gina Glover.

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Is there evidence that making or seeing artworks helps children's health? To be honest I could find no formal evidence other than one small before-and-after study,5 but I did not expect to and I do not think it matters. Art is so obviously therapeutic and uplifting, this is an area where formal evidence is superfluous.

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