Gros Morne National Park, credit Zack Matcalfe

Water for the Weary

Why Physicians Now Insist We Go Outdoor

I was raised on the Teeswater River in southwestern Ontario, minor when compared to the neighbouring Saugeen but to me, it might as well have been the Mississippi. We owned the land on either side, connected by a narrow bridge suspended above its rapids, tumbling over the ruins of a very old dam. It was the sort of private wilderness which seems absurdly luxurious to me now. Everywhere on the property you could hear the water’s low rumble, and whenever it pleased me I would walk the woods which bordered the current, or cross the bridge over and over for no particular reason.

When I moved to rural Prince Edward Island in early adulthood, I began to run on the Confederation Trail, either six kilometres west to Leard’s Pond, where I could watch its water empty through another derelict dam, or six kilometres east where a minor wetland narrowed beneath a footbridge. Years later, in Halifax, I’d walk daily from my apartment in Pollett’s Cove to the York Redoubt National Historic Site, where I could sit and watch the Atlantic Ocean smash against coastal rock, then recoil with the music of settling pebbles. When I moved to another apartment in Bedford, I became a regular feature of Hemlock Ravine Municipal Park, where I’d run or walk the length of a small stream, cutting continuously through a stand of ancient hemlocks.

Believe it or not, I never once sought these places out. Within weeks of settling into a new home, I followed my feet to the nearest collision of forest and stream. Within a few months I’d incorporate that spot into my regular routine, all quite unconsciously. I’m reminded of the first chapter of Herman Melville’s Moby Dick, in which its protagonist, Ishmael, describes the draw of water in several dozen pages of glorious metaphor:

“Let the most absent-minded of men be plunged in his deepest reveries,” wrote Melville, “stand that man on his legs, set his feet a-going, and he will infallibly lead you to water, if water there be in all that region.”

I’m without a sacred spot at the moment, having just moved again to the heart of Charlottetown, PEI, but like Melville’s most absent-minded of men, I’m sure I’ll find something. In the meantime, however, I squirm, like a worm drawn from the dirt and set upon a flat stone. I feel an itch, a vague unease, a mute protest in my bones, to borrow a phrase from George Orwell. It might sound foolish, but without the privilege of greens and blues in my daily life, I find it more difficult to escape my own head, to transcend the nonsense which afflicts the modern Canadian, to find a reliable peace. My life is far from a drama, and I have seen more of this country’s natural beauty than most, but without regular doses of nature, I feel like I’ve lost a friend and confidant, and more than once I’ve traced my bad mood back to a lack of local wilderness.

I now know this longing to be inherent to the human animal. Parents immemorial have been howling about the virtues of time spent outdoors, but now the same message is being trumpeted by the peer-reviewed literature, some of its discoveries charming, some of it bizarre.

Among children, regular doses of nature have the long-term benefits of improved self-esteem, vision, body weight, attention and overall academic performance. In surgical recovery rooms, patients with windows overlooking greenery are less dependent on painkillers than those without. Having 10 more trees on your city block improves self-perceived health equivalent to being seven years younger, or $10,000 a year richer.

A study from 2020 followed 36 Finnish daycare children as their playground was transformed from primarily gravel to primarily forest, sod, flower and peat. After 28 days in this wilder setting, their skin and gut microbiota became more robust and diverse, while markers of immune health and anti-inflammatory function surged. Another study from last spring found that access to green space reduces the instances of, and offers relief from, simple loneliness. Yet another paper from last year found that natural soundscapes, such as parks where you could hear more birds than car horns, were powerful antidotes to stress and anxiety, and were a boon to cognitive health. Of all the sounds they studied, none were more potent than flowing water.

These papers aren’t difficult to find, their authors employing everything from surveys and self-reporting to blood tests, ECGs and electroencephalography. The literature is now bursting with validation, linking time outdoors emphatically to physical and mental wellbeing. This comes as no surprise to students of deep time. We’ve been primates for several million years, and Homo sapiens for 200,000, and the only constant throughout those millennia of cognitive evolution has been wilderness in one form or another. Even our recent ancestors in the 19th and 20th centuries spent more of their time in nature than not, but today, we are less wild than we have ever been, thanks in part to things like urbanization, privatization, deforestation and defaunation. This sudden absence of nature is, at the very least, unhealthy.

In Canada, this message has found its champion – Dr Melissa Lem. A devotee of the evidence and a diligent family physician, she’s been prescribing time in nature for over a decade, initially to treat mental health conditions like ADHD, depression, stress, anxiety and even concussions, but as the literature expands, so do her prescriptions, now covering mental, heart, lung and immune system health generally. Side-effects may include greater longevity, increased energy, improved pain management and the bettering of mood.

When I first spoke to Melissa in the summer of 2019, she was preparing to launch a formal nature prescription program, so healthcare providers across British Columbia could begin recommending the outdoors to their patients, typically for a set number of hours per week. And it worked. When this program launched in November of 2020, it was so wildly popular that Melissa expanded to Ontario the following February. By summer, they’d launched in Saskatchewan, and by fall, Manitoba.

Healthcare providers consistently rank among the most trusted professionals in the world, she told me, and when they deliver a prescription in the context of an individual’s health, that individual tends to listen. What better way to drive a paradigm shift? The nature prescription program, PaRx, is only available to members of healthcare associations which have formally joined, and even then, the individual doctors and nurses must sign up for access to the relevant prescription framework, presently offered through the BC Parks Foundation, but uptake has been swift, and PaRx will have a foothold in every province by the end of 2022.

Only in the last few weeks, these prescriptions for nature have achieved a whole new calibre, not only insisting that people get outdoors, but granting them access to the wildest sites in the country – those under the purview of Parks Canada.

Once a month, while seeing patients for any of the conditions mentioned above, it will be within the power of healthcare providers to prescribe a Parks Canada Adult Discovery Pass, providing free access to national parks, national historic sites and even marine protected areas for the people who need them most. It’s a remarkable feat of accessibility, in an era when nature has become a privilege.

These passes will not be handed out like candy, and not everyone in need of nature will be an appropriate candidate, but this program and its partnerships are still expanding, and will play no small part in bringing the restorative values of time outdoors into the mainstream.

To this day, when I am crestfallen, anxious, beaten or afraid, my mind strays involuntarily to the Teeswater River, to Hemlock Ravin, to the decommissioned dam of Leard’s Pond and especially to the York Redoubt National Historic Site, whose crashing coastline could now be opened to many a weary soul by the prescriptions of PaRx. It is important, as we recover from this pandemic as individuals and as a society, that we each find a sacred spot of our own, to recover what we’ve lost, with or without a note from our doctor.


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Eastern Perspectives

Zack Metcalfe is a freelance journalist, columnist and author based in the Maritimes.