The Healing Power of Nature | Meet Dr. Melissa Lem, The Doctor Who Prescribes Nature - Inner Path Seekers | A space for mental health

Episode Transcript
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(00:00):
I think a better question is what health condition isn't
nature good for? There have been these big meta
analysis looking at a huge variety of health conditions
from high blood pressure to cholesterol issues to pregnancy
outcomes, cancer care, anxiety, depression, and almost across
every single health condition. Spending time in nature and

(00:23):
having access to nearby nature is an evidence based benefit.
What's up there, everyone? Welcome here to another episode
on the IPS podcasts. I'm Ellis Fast, your host and
the founder of the IPS project, the educational platform on
Life. This episode is honestly one
that I'm really excited about. So I'm really excited to finally

(00:43):
release it out and to have you here join me because we're going
to talk about nature. I mean, I personally have such a
love for nature as a kids. I used to love, you know,
spending time outdoors. But as an adult, that Love
Actually grew even more. I mean, I've had the chance to
travel to many countries, I've done many multi day hikes, I've

(01:07):
climbed many of the highest mountains around the world.
There is something about nature and being in the great outdoors
that just, I mean, it just feelsgood, right?
And you know what? There's actually a whole bunch
of studies spanning from a decade ago showing how good it
is for our physical and mental health to spend time in nature.

(01:29):
Therefore, I was really excited to actually zoom into that topic
even more and to really look into all the benefits that
nature has for our physical and mental health.
And for that, I went out to search for a qualified experts
and I stumbled upon Doctor Melissa Lam.
Now, Doctor Lam is a Vancouver family physician, an

(01:51):
internationally recognized leader in nature and health and
the director of PARX, which is an initiative of the BC Parks
Foundation. Now this initiative, driven by
healthcare professionals, aims to improve patients health by
connecting them with nature. So yes, Doctor Lam, along with
other doctors who are registeredat PARX, is a Doctor Who

(02:15):
prescribes nature to her patients.
Which sounds, I mean, funny enough, revolutionary.
Therefore, I'm excited for you to jump into the interview to
learn in depth about all the physical and mental health
benefits that nature has. Because it's honestly a whole
list of things. Now, to find any of the
resources mentioned by Doctor Lam, check out the show notes,

(02:38):
which are, as always, located inthe description of this episode.
Or you can also go directly to the ipsproject.com/podcast and
search for Doctor Lam. All right, with that, let's dig
now into the interview with Doctor Lam.
Doctor Lam A warm welcome here to the IPS podcast.

(03:01):
I've been honestly looking forward to this episode quite a
for quite a few days, so I'm really thrilled to finally have
you here on the show. Thanks Ellis.
It's amazing to be talking to someone from across the ocean.
When I was actually preparing for this interview and when
people were asking me like, who's gonna be the new guests on

(03:24):
the show? And I told them like, well, it's
this doctor from Canada who prescribes nature to their
patients. Honestly, everyone immediately
said, like, that's amazing, moredoctors should do this.
Is there something coming to your mind why so many people

(03:44):
seem to have such an almost innate and instinctual response
to say that, That it's amazing that doctors actually, or that
there is a Doctor Who does that?I think one of the reasons is
people are looking for non medication ways to manage their
health issues, whether it's mental health concerns or
physical health concerns. We're always looking for

(04:06):
evidence based interventions andI think the fact that a doctor
might be prescribing nature, which is something that for
example, I don't get any money to do, I really do it just
because I know and I've seen it improve my patient's health is
is kind of revolutionary. But The funny thing is it's
really something that's that's back to basics when it comes to

(04:28):
health. In Canada in particular, we talk
a lot about preventative healthcare and how it's
important to have a healthy diet, exercise regularly and get
good, good quality sleep for healthy lifestyle.
But we like to call nature time the fourth pillar of health in
our program because the evidencebehind the health benefits of
nature is so overwhelming. And I think it's really my job

(04:49):
as someone who wants healthier people on a healthy planet,
knowing this information and andhaving the platform that I do
and the skills that I do to communicate this to the public
and decision makers. So we can get more nature in our
city, so we can get more people outside into those green spaces
to improve health. Yeah, and we're definitely going
to talk about Parks, of course, in the interview.

(05:10):
But first, I actually saw not too long ago, like about a
month, I think on your LinkedIn page that one of your childhood
heroes, Doctor David Suzuki, invited you for a coffee.
And I mean, I actually, because he's quite a famous person in
Canada, right? I did not know about him.

(05:31):
So actually also thank you for kind of introducing me to him
because he seems like such an incredible human being.
So a few questions on this Who is Doctor David Suzuki, for
those who don't know who he is and what makes him one of your
childhood heroes? And plus also, why did you meet?
Doctor David Suzuki is probably one of Canada's best known

(05:55):
environmentalists and best knowncommunicators.
I think he really came to prominence in kind of the the
middle to late 20th century whenhe started appearing on CBC, the
Canadian Broadcasting Corporation, which is our
national public broadcaster on television and on the radio to
educate people about different aspects about the environment

(06:17):
and nature and also to inspire them to want to protect it.
So he's one, one of the first. He's one of the OG
environmentalists in Canada. He also founded the David Suzuki
Foundation, which does amazing work on nature conservation and
work on climate action. And he's still, I would say,
even though he's now 87, one of Canada's best known fathers of

(06:40):
the environment. And I remember growing up in
Toronto and watching the nature of things, which was his his
show on the CBC, on television. And I think also the fact that
he was he was a racialized Canadian.
He, his background is is Japanese.
And the fact that someone who kind of looked like me could be

(07:00):
on television and be talking about these things that I really
cared about as a child as well, was incredible.
And this was, in fact, the thirdtime that I've met Doctor
Suzuki. But the first time that he
invited me. Yeah, he probably doesn't
remember, to be honest. I was just part of one of his
crowd of adoring fans or whatever.

(07:21):
But I met him once in Toronto when I used to live in Toronto.
He was talking with Doctor Richard Louv, who's the author
of The Last Child in the Woods, an amazing book about nature
deficit disorder and how it it'simpairing Children's Health.
And they were talking at the ArtGallery of Ontario.
And I'd written A blog entry forthe David Suzuki Foundation

(07:43):
about the health benefits of nature and how it reduced
stress. And so the the foundation
invited me to this event. And I remember, I remember there
was this VIP reception, this is over a decade ago where Doctor
Suzuki was there. And I remember thinking, OK,
this is my chance. I can tell him how much he means
to me. And so I kind of scuttled up to

(08:06):
him and and blurted out this verbal diarrhea about how he was
my hero, about how I followed his work my whole career.
And I can just, you can just imagine what it's like for
someone like that to be approached by members of the
public all the time. And he was very gracious, He was
very lovely and and kind of nodded his head and smiled
benevolently. The second time was in fact more

(08:27):
wrapped into the environmental work that I do.
We invited him to help open up an event where we were talking
about the health impacts of fossil fuel extraction within.
And I in fact, did a prolonged interview with him about his
views on that. But I think it was really after
kind of he, he has great interest in fact in human health
and the environment. After doing some intersecting

(08:49):
work on that with the the Canadian Association of
Physicians for the Environment, which I'm president of right now
and the David Suzuki Foundation that he decided to to reach out
and say we should go for coffee.And it was.
It was. Amazing.
It was a great conversation. It was an amazing moment, a
watershed moment for me. Yeah, and.
And so why did you meet each other?

(09:09):
Like, why did he invite you for a coffee?
Like what you do that day for you know?
He, in fact, was invited to givea keynote at at the Canadian
Association of Physician for theEnvironment, Physicians for the
Environments or CAPES annual general meeting.
And then in conversations afterwards, he the the past
president and I. It's kind of a dry story anyway.

(09:31):
It's all about e-mail connections.
This is how we communicate thesedays, said hey we should meet up
when we're I'm in Vancouver. And then David said, Oh well why
don't you invite Melissa as wellto this meet up And then we
arranged our own meet up outsideof that.
But it was really a long time incoming because we had another
conversation prior about potentially meeting up.

(09:53):
But that was what catalyzed it was an online Zoom meeting where
he keynoted our ATM. How amazing is it to meet your
hero in in, you know, real life and and then also actually at,
you know, now actually working with him?
It sounds like quite an amazing thing actually.
I think that's one of the coolest things about working in
this space, about working in theenvironment and health and

(10:15):
nature space, is the incredible people you meet.
People often ask me what's the best thing about it, and not
only is is hearing my patients the stories for my patients
about how nature time has improved their health in
tangible ways. That's very rewarding.
But meeting really cool people is also is also a great aspect
of this work. For sure.
Definitely. It reaches your life as well,

(10:35):
right? So, yeah.
OK. So you launched in 2020 Parks
and please correct me on anything that I'm getting wrong
right in collaboration. With PARX.
PARX, it's pronounced. PARX, just so you know, that's
OK. Well, The thing is, I don't know
if in the Netherlands you have if RX means prescription, but in

(10:59):
English, like in North America, RX stands for prescription.
OK, Because I was actually looking on YouTube for other
people who who you know how to pronounce it.
And some people said PARX and others I thought said parks.
But OK, it got me a little bit confused.
So PARX, so you launched it in 2020, right?

(11:20):
In collaboration with the BC Parks, now in shorts.
PARX is an initiative of the BC Parks Foundation that is driven
by healthcare professionals who want to improve their patients
help by connecting them to nature.
Now what I'm curious about is what, you know was the turning

(11:40):
point for you as a physician wholikely, well as many physicians
probably did not learn a lot about the benefits of nature in
Med school. You know what was the turning
point for you to decide? This is what people need.
This is what I have to start. It was really a personal
experience with nature deficit that spurred me to start

(12:04):
advocating at this intersection.My first job was as a rural
family doctor in northern BCI. Went straight from training to
in Victoria, BC up to the north and suddenly was a full service
royal family doctor where I had to do a lot of pretty stressful
things if you're objective aboutit, delivering babies in the

(12:26):
middle of the night, running theemergency department.
We were only family doctors in ain a hospital where a lot of
different a lot of sick people came in and if you imagine this
person in their mid 20s who justwent from a learner to staff it
was a it was a objectively stressful experience.
But in fact I loved the work an incredible amount and and when I

(12:47):
moved from northern BC to downtown Toronto which is in
fact where I was born, suddenly I moved from a place where there
were mountains and ocean and bears walking across my
driveway. Actually, there was an ocean.
Sorry, that's where I live now, in Vancouver mountains and the
amazing Skeena River and forest.And bears.
To concrete and glass, exactly. And bears, which I love, by the

(13:08):
way, and deer it. Suddenly I felt a lot more
stressed, even though the work itself was objectively easier.
I was doing outpatient student health with without patients of
car accidents coming in, or momsand labor, anything that
required immediate attention. It was pretty low acuity work

(13:30):
and I felt a lot more edgy. And I still remember one day
standing at at my window and looking out and listening to the
noise of the street, of the streetcars rattling by and
looking at all the people and thinking, do you know what I
think I'm missing? And do you know why I think I'm
feeling so stressed is because I'm missing nature and this was

(13:51):
just this intuitive sense that Ihad because I was still going to
do rural locums as a doctor I SoI would both work in the city
but also go to to other places in Northern Ontario or in for
example, the Northwest Territories or even in BC and
work. And I could feel the difference
in myself, even though again, I would go do more stressful rural
work. I felt more relaxed Despite

(14:13):
that. And I thought, do you know what
it is? I think I'm missing nature.
And as a as a good evidence based Doctor Who doesn't believe
anything unless it's backed up by randomized controlled trials
and papers and research, I thought, OK, well there, I mean,
this intuitive sense can't be real unless it's backed up by
the evidence. And so I did this big lit
review. This is close to 15 years ago

(14:34):
now, looking for search terms like nature, health medicine,
health benefits, and hundreds ofstudies popped up about the
health benefits of nature. And this is something, as you
mentioned, I'd never learned outabout in medical school.
I I really was not hearing anyone talking about it at this
point. And I thought, do you know what?
This is a big gap in our healthcare system.

(14:54):
This is a big knowledge gap among my colleagues and I want
to do my best to make sure that everyone knows public decision
makers, my colleagues, about these evidence based health
benefits of nature. So that was my turning point, a
personal nature deficit experience leading to my
discovery of this evidence base and then wanting to work to make
sure everyone knew about it. It's kind of a bit of a nerdy

(15:15):
story that involves a lit review, but that's the trick.
It's a. Good story.
Yeah, but. And and when did you then decide
to actually take steps on this to actually make PARX?
It was when I connected with theBC Park Foundation after moving
back to British Columbia that I found that they were looking to

(15:36):
launch a nature prescription program.
They had a lot of foresight, I would say, because a lot of
nature foundations focus on conservation, but they really,
really wanted to 0 in on human health because that's really a a
big motivator. And this is also backed up by
the research for people to support policies and for people
to support initiatives. When they can feel the benefits

(15:58):
of nature themselves, they will fall in love with nature and
want to protect it because you want to protect what you love.
And so they wanted to launch a nature prescription program.
I've been thinking about it for years at this point, but I
thought, I'm one doctor. There really aren't a lot of
people like me in Canada. How am I supposed to launch a
nature prescription program around my practice and
everything else that I do? And so is really having access

(16:20):
to staff and resources and the credible name with the BC Park
Foundation that that allowed us to make it happen.
And I became director of Parx in2019 and then worked steadily to
launch Nature Prescriptions by November 2020.
And I mean, for people listening, right, listening now,
how does it work? Because, I mean, most people

(16:43):
know, OK, you go, you know when when you go to a doctor, you
might get a prescription for medication.
You know, you go to the pharmacy, you get, you take the
medication for X amount of time.But what about nature?
Like how, how do you get a prescription for that?
So maybe first of all for who isthis?
Like when a patient's come, whena patient comes in, what can

(17:07):
nature treat, What are the things that nature can treat?
And then, if this patient could benefit from it, how does it
look in practice? I think a better question is
what health condition isn't nature good for?
There have been these big meta analysis looking at a huge
variety of health conditions from high blood pressure to

(17:27):
cholesterol issues to pregnancy outcomes, cancer care, anxiety,
depression, and almost across every single health condition.
Spending time in nature and having access to nearby nature
is an evidence based benefit, soyou could really prescribe
nature to anyone. That said, I would say the
majority of nature prescriptionsof prescribers in our program

(17:49):
tend to be for mental health issues like anxiety and
depression because I think I think that feels the most
intuitive. Even though the evidence is
there for chronic diseases like diabetes and high blood
pressure, people think about that less because you can't feel
your blood pressure going down, you can't feel your sugar going
down when you step into nature, but you can feel a sense of calm

(18:11):
and better focus when you when you walk into nature.
So yes, I would say through our program the majority are mental
health prescriptions, but it could be for for really any
other condition. And why does why does it work
actually? Like what is it about nature
that it does to the, you know, minds or brain and body that

(18:32):
makes it so effective for so many different conditions?
There are a couple of major psychological theories about why
nature is really good for our brains and and gives our brains
a break, and the first one is called attention restoration
theory. And when we spend time in busy
city environments that have so many different stimuli competing

(18:54):
for our attention, like traffic lights, crowds, noises, sure,
that tires out our powers of conscious attention which we
only have a finite amount of. There's only so much attention
in the bucket, and once you passit it, it starts to overflow and
make us more irritable and tiredand lose focus.
But when do you step into nature?
A park or a forest or by the water?

(19:15):
It's a source of soft fascination that's interesting
but doesn't require that that focused attention that
navigating around a sidewalk andacross the crosswalk and through
traffic requires, and that restores that power of conscious
attention and reduces our fatigue and irritability.
There's another major theory called stress reduction theory
that says that when we spend time in nature during periods of

(19:37):
stress and after immediately after periods of stress, that
nature helps our brains recover faster because it's naturally
restorative. And this can go back to when you
think about human evolution. So if you think about areas with
high biodiversity, they tend to have lots of sources of, of
food, of things that you can useto build shelter, of water, of

(19:59):
say, trees that you can climb upto get away from predators from.
So having this biophilia or preference for?
Nature is really an evolutionary.
Benefit. Yeah, makes sense.
Passed on these nature loving genes to future generations.
And then because of this reduction in stress, when you
step into nature, your primary stress hormone or cortisol
levels drop. And we know that cortisol is bad

(20:20):
for all kinds of different health conditions from high
blood pressure to diabetes to cancer.
And then also it's it's what we touch and what we smell in
nature that also improve our health.
There are these volatile organiccompounds called phytensides
that plants and trees release. If you think about a cedar or a
pine forest and that that nice smell that you get when you walk

(20:40):
into that forest, you're breathing in these chemicals
that in fact boost your levels of natural killer cells and
immunoproteins. And then when you touch nature,
you get your hands in the soil or touch the trees, you are
getting healthy bacteria on yourskin that that make your that
help your immune system move in healthy ways towards being
defensive against viruses and bacteria as opposed to more

(21:02):
allergies. So there's so many different
ways, from from our brains to our noses, to like our digestive
tract and to our our stress system, that nature is improving
our health. And then of course, you have the
physical part to it too, right? When you are in nature, you
might be walking around, which is, you know good for everyone

(21:23):
to just move. I actually move moved from
Antwerp, so one of the cities inBelgium to my hometown again,
which is just a lot more green. And I can, yeah, honestly feel
so much. I sleep so much better.
So many less noises at night. And yeah, it's it's it's so good

(21:45):
to just walk again in a forest abit more.
It feels amazing because there'salso noises in the in a forest,
right? But they're more calming noises
compared to the noises of of cars and I don't know, and all
the machine thing, yeah, any drills that you hear somewhere
in the distance or something. And when you hear those animal

(22:07):
noises and you hear the sounds of nature, they they tell your
brain, hey, there might be a source of food here or or hey,
there's something here that I can that I can use to eat or you
know, or used to build a shelter.
It's they, they are signals thatare positive for our health as
opposed to drills and traffic that are generally negative for

(22:27):
our health. Yeah, I actually read when I was
preparing for this interview, a whole bunch of studies also
about the benefits of nature forour mental health and our
physical health. And there was one that actually
I thought was just mind blowing to read.
And it has been shown multiple times apparently in other
studies but that patients who have who are in the hospital and

(22:51):
who have a window with just you know green with with trees
healed on average. And let me see that I get it
right. Healed on average a day faster,
needed significantly less pain medication and had fewer post
surgical complications than patients who just saw a brick
wall, which I mean that's insanethat nature can have such an

(23:16):
impact on our mental and our physical health.
Actually, are there any other interesting findings such as
this one about the impact of nature on our physical and
mental health that you know, that you often feel other people
don't fully know or understand? Are there any other studies
coming to mind or anything? Yeah, coming to mind on this

(23:40):
question. I want to add something to the
study you just mentioned and these patients not only got
discharged earlier, used less pain medication but their
healthcare providers also found them less bothersome when they
were able to look out at at to nature of their windows.
So it makes us happier too, not only that our patients are
healthier but that but that theythey interact in more positive.

(24:01):
Yeah, it makes work easier for you too.
Exactly, exactly. In terms of other need studies,
I would point to the fact that there are studies showing that
you don't necessarily have to move when you're in nature to
get those health benefits. And you mentioned the exercise
component. That's definitely one pathway by
which we can improve our health when we spend time in nature

(24:23):
because we know there's a huge amount of evidence behind the
health benefits of exercise. But you don't even have to move.
There are studies showing that if if you just sit in nature for
15 minutes in a forest versus ona city street, that your
cortisol levels drop, that your blood pressure goes down, that
your heart rate variability improves.
These are all markers of stress.So taking a break, like even if

(24:46):
you don't feel like exercising. I personally love to exercise
and hike and do all those things, but there are people
that can't that have mobility issues or just don't have energy
to do so. If you just sit on that park
bench or sit by the river or ocean or look out your window,
even if you're stuck inside at nature for 15 minutes, that can

(25:09):
improve your health also. So it's not just that exercise
benefit that improves people's health, it's it's the stress
reduction in many ways that thatbeing around nature helps with.
And which actually reminds me also, just when you for example
would give a prescription to a patient that could need or could
use the benefits of being, you know in nature how long this

(25:33):
might vary depending on the patient, right?
But how? What is the general rule that
that works best? How long do they have to be in
nature? Do they have to be every day in
it for hours or or every week? What in general works on average
do? You know what the really cool
thing is? At the time when we were coming

(25:54):
up with our nature prescription program recommendations around
dosing, nature dosing were starting to come up in the
literature. And there was a paper released
in 2019 that looked at recreational time in nature in
adults in the UK, close to 20,000 adults and self-reports
of health and well-being. And they found that when their

(26:15):
time in nature hit at least two hours per week that they
reported significantly greater health, well-being and this
health and well-being. And this was this was controlled
for a number of other factors like income and pre-existing
health status and proximity to nature.
Because you think OK, often people who live in wealthier
environment, healthier environments have are more, have
more exposure to nature, tend tobe wealthier.

(26:37):
Of course they're going to report greater health and
well-being if they spend more time in nature, but they
controlled for a lot of those different confounders, which is
really neat. There was a second study that
came out again in 2019 that looked at how much each nature
pill has to be. How much time should you spend
in nature each time to get the biggest bang for your buck?
And it turns out that the biggest drop in cortisol, that

(26:59):
stress hormone, was between the 20 to 30 minute mark, the
steepest drop. And I know a lot of us are
really busy people and sometimeswe only have so much time to get
a health benefit like get it exercise in or or something
that's good for a health in. And it's it's really that 20 to
30 minutes is the sweet spot. Now when it comes to two hours,
at least two hours a week, at least 20 minutes each time.

(27:21):
No one's saying you get your twohours, you get your 20 minutes
stop, you're done. More nature.
It does tend to be better up to a certain point.
So of course if you're feeling great, if you're enjoying that
hike with friends, stay out for longer because the health
benefits do improve over time asyou stay out up to the study set
say about 5 hours. And I want to mention something

(27:41):
actually a personal experience that has to do with this two
hour, this two hours in nature per week benefit I'm actually
part of. I'm an international advisor for
an international trial research project called RESONATE which is
looking at nature based therapies and health outcomes.
And I was at the 1st Annual kickoff meeting in Vienna in

(28:05):
this in September of 2023 and I met the principal investigator
in person for the first time andI was presenting to the group
this is, these are these esteemed researchers from mainly
Europe who are all looking into nature based therapies and
health. And you know I felt like a bit

(28:25):
of an imposter. I'm like this family doctors,
this is nature prescription program.
I'm not this esteemed researcherand I was presenting on our
guidelines what we recommend fornature dosing.
And then the principal investigator, his name's Doctor
Matthew White. He actually said, I wrote that
paper on the two hour per per week nature recommendation.

(28:47):
I'm the first author and we deliberately wrote that paper to
speak to health professionals who who were asking for dosing
information. And it's incredible that here we
are in this room together now, leaning on each other's work and
inspired by each other's work. So this was really a full circle
moment. They they spoke, the researchers

(29:07):
spoke, and I listened. And the rest is history, right?
Yeah, wow. But two hours a week?
That's honestly not long for quite some good positive impacts
on your mental and physical health, right?
So, 'cause like you said, some people listening might be like,
oh, cool, you know, being in nature.
But I already have so many things to check off, you know?

(29:29):
Got my work, gotta work out. Now I also have to be in nature.
So yeah, just having maybe a walk for 10 or 15 minutes a day
could already be huge. Or you can incorporate nature
time into what you already do. Like if your if your work
commute involves you can try to ride your bike or or walk

(29:49):
through along a tree lined street or through a park if you
can. If you are socializing with a
friend, grabbing coffee, take take the coffee to go and walk
in a park, you can do do your workout, do your cardio.
In particular in nature. It doesn't have to be an instead
of it can be. It can be incorporated into what
you do. Before we continue with the

(30:11):
interview, I just like to take amoment to mention.
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(30:35):
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(31:18):
description of these episodes. Having said that, let's return
back to the interview and by theway, because and maybe maybe it
sounds a bit sad for me to ask this, but I was looking not too
long ago actually at photos frommy hometown of like 50 years

(31:39):
ago. And there were a lot more fields
and trees compared to now. I mean there's a lot more
buildings where those fields andtrees were.
But when like how much nature doyou need for it to actually
work? Because you said a park, but
compared to a National Park, does a just a City Park work

(32:03):
just as as good as well or does a even like a tiny garden?
Because some people might, yeah,just have only a tiny garden and
not so many city parks either. Does that also work?
Like yeah, when do you have enough nature?
When is it? When is it effective actually?
What the research does show is when you feel like you've had a

(32:26):
meaningful nature experience is when you're going to get those
health benefits. So the objective biodiversity,
number of trees, that sort of thing, number of birds, doesn't
necessarily matter as much as when you feel like you've had
that experience. So if you feel like you've
connected to nature, when you'rein your garden or if you're in a
City Park or elsewhere, you'll see those health benefits.

(32:46):
And I will point to this three 3300 rule that one of my
colleagues, Dr. Cecil Canine andDyke, came up with, and he was
originally based at the University of British Columbia,
where I'm a clinical assistant professor.
But he now works in the EU. And this rule, and it's backed
up by evidence, says that we'll know that our cities are healthy

(33:06):
from an an infrastructure perspective.
When everyone in every neighborhood, not just the rich
ones, can see at least three mature trees from their windows,
when they when every neighborhood has at least 30%
tree canopy. And when everyone is within a
300m walk from a high quality green space.

(33:27):
And this is backed up by this isbacked up by research, for
example from some of my colleagues in Australia.
I've I'm also participating in it in another research project
with them that looks at that lowest, the quartile of nature
and tree canopy within city neighborhoods and then anything
over 30% and they find that conditions from sleep issues to

(33:52):
loneliness to heart disease and high blood pressure are are
significantly lower. Once you hit that 30% tree
canopy level. Exactly, Yeah.
It's really interesting how. Would loneliness because you get
out and meet people maybe? Or how would it?
That's one of the mechanisms. That's a great question and they
would be great people to interview for another podcast.

(34:13):
But nature, I think because it'sit relaxes us like we feel
calmer when we're outside in nature.
It facilitates those social connections.
And I think you really, you really see this in kids, in the
research, in children when they play in green playgrounds versus
playgrounds that have jungle gyms and plastic and and metal

(34:34):
structures, they play more cooperatively and there's less
conflict. And I think it's it's a function
of of it being kind of an equal space for everyone to interact.
And and we see that in other research where it shows that
health disparities reduce in in neighborhoods that have more
nature in them between people who earn low income versus high

(34:56):
income. It's really this great equalizer
for all. Of us it is right?
And wait, it was 3300 or or whatwas it?
It's the three 3300 rule and what's interesting too is that
there are different cities that are in fact taking up this
guideline. The city of Victoria, which is
where I in fact did my family medicine training has has added

(35:20):
this in policy and they're aiming for their city to to fit
the three 3300 rule. And I think it'd be amazing if
more and more cities everywhere in the world started taking this
up because we we we would see real benefits for human health
and benefits for the city as well.
Like when you have more trees, it reduces the urban heat island
effect, it filters the air, alsoreduces flooding when there's

(35:42):
heavy rainfall. So there's so many different
winds for health and infrastructure when you add more
nature into cities. Yeah, and it makes people
happier and healthier, like you also said.
So only more reasons to make parks right in cities.
And actually, what about becauseyou also, you mentioned people
with disabilities, right? For people who do have a

(36:04):
disability or or for some other reason can't leave their
apartment, how could a nature prescription actually look like
for them? Is there some way to still
benefit from nature even though that you're indoors?
Any way that you can connect to nature is in some way going to
improve your health. And I want to lean on some of

(36:25):
the work that my colleagues in Ontario are doing.
There's a pediatrician, her name's Doctor Anna Gunz, and one
of her residents, Dr. Comedy AbeTongue.
And they in fact brought in Nature for Healing program into
their Children's Hospital. And they recognize that not a
lot of these kids can go outsidebecause they're sick, they're
hooked up to different equipmentand it's hard to go out.

(36:47):
So they've created a program where they can bring nature to
their patients indoors, and thisinvolves having more plants
indoors. This involves having more nature
imagery and nature sounds around.
And so if say someone is inside their home, and I think a lot of
us saw this during during the lockdowns of COVID-19 when a lot
of people didn't necessarily feel safe to go outside into

(37:08):
green spaces because we didn't quite know how the virus
transmitted. If you can have house plants, if
you can play nature sounds, the smells of nature, videos of
nature, there is research showing that that can improve
mental health outcomes in particular.
So just as much as you can bringinto your home, the better.
And I think we who are in positions where we can speak to
decision makers and and influence public discourse, It's

(37:31):
important for us to emphasize that governments have to step up
and make sure people have green space and trees and plants
outside their windows too, so they can enjoy the health
benefits of nature too, even if they can't get outside all the
time. Yeah, and what you also said, I,
I actually also did read it thatactually seeing a documentary on
nature does also have positive effects on your physical and

(37:54):
mental health apparently. So that's actually quite, yeah,
just seeing any kind of nature, even a documentary, could
already do quite amazing things on on on a person.
I really love those documentaries and I think one of
the big reasons is they're they inspire a lot of awe.
You look at them and you think, wow, I mean, I have this zoomed
in microscopic view of this insect that I've I would never

(38:16):
see in real life. Or just I'm watching the
migrations and movements of these these groups of animals in
another country that I probably won't ever have the chance to
see in my lifetime. It's amazing.
And in fact, that sense of awe is something else that improves
our health when it comes to nature.
Because you you, you see your place in the universe a bit
better and you understand what'simportant.

(38:39):
It puts things in perspective and it gives your brain a break
while you're doing that. So nature is really good for
inspiring that sense of awe, andI think documentaries are really
good for that in particular. So for someone listening right
now who after everything you know that you've shared about
nature, who feels inspired or orcurious to to actually

(38:59):
incorporate nature more in theirday or in their week.
Do you have any other just general suggestions for anyone
listening to make in in a way the most out of nature you know
when they're out there or or or to to to feel the most benefits
out of nature. Is there anything more of a yeah

(39:20):
something that you could share to someone listening who who
wants to incorporate nature morein their in their life?
First of all, I would say remember our standard guidelines
to spend at least two hours in nature a week, at least 20
minutes each time, and try to make it a meaningful experience.
Be as present as you can and as mindful as you can about your
surroundings. Another way I think to enhance

(39:43):
your experience is to engage family and friends.
We know that the social aspect, connecting outdoors is really
good for our health too, and if you can do it in nature, all the
better. Not only that, but they'll keep
you honest if you tell them. If you tell people I plan to
spend at least two hours in nature each week, then then
they'll they'll hold you to it and they'll get healthier at the
same time. And I think finding something

(40:04):
that you enjoy as well, and thisis this is important for for any
new habit that we pick up, whether it's exercise or diet,
this is a prescription for life.This is not a prescription for a
few weeks or a month. You want to make sure that you
you do this forever and so finding something that that you
like, that you can keep up and that you can do with others, I
think is these are all important.

(40:25):
Yeah. And also like, if you can
combine it, you know, like you also mentioned, for example, if
you could have every, I don't know, every two weeks, maybe a
fixed day and time to go for a hike with some friends, which
kind of checks off multiple things, right?
You're in nature, you spend timewith friends or or family, so

(40:47):
you're social as well. You're maybe also seeing new
things. I actually used to do that that
I went on a on a hike with friends every month and yeah, I
should probably start doing thatagain.
But but it was a really awesome way for me to check off in a way
multiple things. So yeah.

(41:09):
That's right. And we can think about this
pyramid of nature experiences, like the everyday nature
experiences, the 20 minute bursts maybe in your nearby
nature, but then maybe once a month go on a hike or a nature
experience somewhere further afield that has more
biodiversity and is a is a bigger nature spot.
And then maybe once a year, liketake a prolonged camping trip or

(41:30):
a vacation somewhere surrounded by nature, yeah.
That's good. It's maybe a bit of like an
analogy of like, you know, everyone needs to eat every day
and you might you cook every daymaybe for yourself, but maybe
once every month go on a really nice restaurant and let someone
else you know, cook for you. But to have also a whole
different experience. It's nice to.

(41:52):
Yeah, that's that's a good situation.
Actually. Yeah.
When a patient come comes back to you, you know, one that you
prescribe medication. Sorry, not medication Nature to
how do you assess actually the effectiveness that you know that
the nature treatment worked for them.
Are there any specific metrics or or tools that you use Yeah to

(42:16):
to to see if it was effective. And also, for people listening,
what could they do to see if nature is actually being
beneficial to them? Well, the first thing I do want
to follow up with a patient I prescribe nature to is ask them
if they're indeed spending time in nature to see if they've
picked up a nature habit. The vast majority of the time
they say yes. And I do have to say that I'm

(42:38):
very lucky to live in a neighborhood in Vancouver, BC
that is filled with nature. So we have pretty easy access to
beautiful second growth forest trails and ocean and all kinds
of parks. So it's not hard for them to
fill their nature prescription. So the most of the time they
come back saying yes and then itdepends on the condition.
I would say just like most of mycolleagues, I prescribe the

(42:59):
majority of nature prescriptionsto patients with mental health
issues and I can't think of one patient I prescribe nature to
who hasn't gotten better in someway.
And there's some different scales that we use, for example,
to assess people's mood, depression and anxiety skills.
And they almost invariably improve.
And I can't say for certain, being completely honest here,

(43:23):
that it's the nature prescription that did it all.
Sometimes I will prescribe counseling in addition or
sometimes medication in addition.
It's not one or the other, but it's really part of an overall
treatment plan that improves patients health.
And it's and it's evidence basedin terms of patients, other
people, not just people listening to this podcast about

(43:45):
how they can tell if nature is improving their health.
If you feel like it is, it is essentially.
And I know that sounds kind of that sounds kind of like a hedge
or something. But it's based on the research
that tells us if you feel like you've had a meaningful
experience in nature, your health is improving, you can you
can track your own blood pressure.
You can see what your stress levels feel like you.

(44:07):
Can go to your doctor. And and get your blood sugar.
Exactly. I think if you, if you take the
time to spend time in nature andthen look to see how you're
feeling both mentally and physically and and measure what
you can, I think you will see some benefits.
This notion that nature can actually be used as an effective
treatment is becoming more of a knowledge.

(44:30):
I'm not saying we're there yet, right?
Not at all. But it seems like slowly things
are changing, right? And it's truly thanks to the
work of people like you that this is happening.
But what I'm curious about is why now?
Why does it seem now that peopleare taking nature more serious
even though there are years and years of, I mean years ago

(44:54):
already there were studies aboutthe benefits of it, but only now
it seems doctors are slowly accepting nature as treatment.
Any thoughts on why that's the case?
There are a few ways I could answer this question and I think
one is the world was ready in 2019.
Nature prescriptions were in fact named one of the top eight

(45:17):
global Wellness trends. This is this is 20/20/19.
And then I think I think the COVID-19 pandemic as well really
drove a lot of people outside because all of the indoor places
where they used to de stress andsocialize were were closed And
so they got to experience first hand the benefits of nature and
it was the right message at the right time.

(45:38):
It's like we're looking for something to improve our health,
reduce our stress that's evidence based and that's safe
and so it's the right message atthe right time.
And then honestly I think it takes people I think it takes
individuals who really have a passion for for A cause really
have a passion for spreading evidence based health
interventions out there. It's and I'm not the only one.

(46:00):
I mean there's an amazing American physician his name is
Doctor Robert Zarr who heads at Park Recs America.
He helped launch the first national nature prescription
program in the world in the US in 2017.
I believe it was and it was really it took one person who
built A-Team and found the resources and made it happen.

(46:20):
So it I think more and more leaders are stepping up now that
they're aware of the evidence base and and and also now that
we're seeing the effects of climate change and biodiversity
and nature loss in our own cities and in our own lives.
I think that's making more healthcare professionals aware
of the effects of the environment on their health.

(46:41):
Yeah, yeah. It's always crazy.
Even though, I mean there's other things right, where that
we know is good but that we're not implementing yet into just
yeah, in in the medical world. So it does take sometimes a
perfect storm for it to be applied like like you said,
yeah, COVID might definitely have something to do with it and

(47:01):
just the awareness of nature of climate change.
So there's probably multiple factors why it's becoming more
used now today, which is good, really, really happy about that.
Is there actually any ongoing research that you're aware of or

(47:22):
that you're even involved in that you're actually very
excited about on the topic of nature and its benefits for
physical and mental health? I'm really excited about this
Canadian National Household Survey, the results that are
which are going to come out thisspring and I think it's OK to
give you a little preview of it.But I was involved in publishing

(47:45):
a paper in Australia looking at what percentage of Australian
adults would spend more time in nature if their doctor
recommended it. And in Australia the number was
over 75% even though many of them hadn't heard about Nature
Prescriptions. They said if my doctor
recommended it, I would spend more time in nature for my
health. We ran a similar survey here in

(48:07):
Canada over the last couple months and we're going to, we
found pretty similar results which is really interesting that
that again the vast majority of Canadian adults would spend more
time in nature if their doctor recommended it.
So I think it's really importantfor more and more health
professionals just to sign up. And then in terms of other
research, I am involved in a couple other big international

(48:29):
research projects looking specifically at nature
prescriptions and nature based therapies and how they can
improve health. And the really exciting part of
one in particular that's that's headquartered in Europe is
they're also looking at ways to most effectively scale up these
therapies around the world, not just increasing the knowledge
base but also implementing theseinterventions everywhere.

(48:52):
So I'm really excited about these two projects.
They're called the RESONATE project based in the EU and and
the PANDA project in in Australia.
So I'd encourage your listeners to to look up those projects and
see what they do. OK, we're up to.
Yeah, I will link it up in the show notes for everyone
listening, so you can find it there.

(49:13):
And as just the last question, like where do you see the future
of nature as a treatment actually going to?
I see more and more health professionals adopting nature
prescriptions as an evidence based intervention into their
practice. And I will say that we've been
around in Canada for about 3 years.

(49:33):
Our nature prescription program,we have registered over 12,000
regulated health professionals across Canada.
In a program in my home provinceof British Columbia, about 15%
of doctors are prescribing nature for their patients
health. They're registered in our
program and we've had endorsements from over 60 major
health organizations within the country, including the Canadian

(49:56):
Medical Association, which represents every single doctor
in the country. And so I see, I see more and
more, more and more health professionals adopting nature
prescribing within Canada and elsewhere.
And something else I see is morelinkages between the healthcare
system and outdoor experience providers because when you
prescribe nature sometime, sometimes patients want to know

(50:17):
well, what can I do and who can I do it with.
And so I think it's it's important to connect also with
the people and the places that provide those nature experiences
to make sure that patients are filling their prescriptions in
an effective way. Yeah, yeah.
Well, I'm very excited only about the future and I am so
thankful and grateful that we have you in this world, 'cause

(50:38):
it's really thank thanks to people like you, right?
That this is becoming more common knowledge and is being
taken serious and that, yeah, it's only being pushed more
towards that direction. So thank you honestly for, for
all the work that you have done,for all the work that you are
doing and just for bringing thisawareness and of course you know

(51:00):
for BARX for for starting that initiative.
Yeah. So thanks.
It's I mean it's my pleasure. I get to speak with people like
you and then I get to help inspire new nature and health
colleagues also across the country and elsewhere in the
world. I do have to say that a lot of
people have stepped out of the woodwork, a lot of other doctors

(51:22):
and nurses and health professionals saying I want to
be part of this movement. How can I help?
And they've really been responsible for a lot of the
spread of our initiative across the country.
So if one person leads often many people will follow and
become leaders themselves. So it's it's great to be part of
the movement. So there's one last end question
that I have for you that I askedall my guests that I would also

(51:46):
love to ask you. But before I will do that, what
is the best place for listeners to, you know, check out your
work or to connect with you? Or where would you want to send
people to? I would get you to check out our
website parkprescriptions.ca. It's at
www.parkprescriptions.ca. We actually have a French

(52:07):
language sister program based inQuebec.
If you'd rather read in French press green.ca and and read all
about the health benefits of nature and and all the media
stories about what our program is up to, we get a lot of
coverage by the media, which is probably how you heard about our
program. Yeah, yeah.
Well, I was actually explicitly looking for a Doctor Who was

(52:31):
doing work around nature and andyeah, that's how I actually came
to find you. And you're also on Instagram,
right? And on LinkedIn.
I don't know you would also if you also want me to link that up
in the show notes. Sure.
Happy for you to add, I think Instagram, LinkedIn and X or
Twitter if you happen to be on that platform.
Yeah, yeah. So for everyone listening, I

(52:52):
will link that up, link that up in the show notes.
So the final question, the end question that I have for you
Doctor Lam and you can take yourtime with his rights.
It can be super short. It can be quite extensive.
From everything that you have seen, experienced, lived, and
learned in your life, what's theone thing you know to be true?

(53:14):
I know that spending time in nature is good for our health
from both an intuitive sense andalso from a research based
sense. And this is something that I've
known since I was a kid growing up in in the suburbs of Toronto
and feeling like an outsider andfinding belonging in nature.
And I would say I've really found my calling within this

(53:36):
space. I've found amazing colleagues
who can help push this work forward.
So I know that when you feel something to be true, and it's
good for you and it's good for the rest of society and the
planet at the same time, this issomething that you should really
pursue because it can. It can result in great things
like a National Nature Prescription Program and like

(53:58):
inspiring these conversations around the world.
And I want to, I want to add onemore thing.
Sure. Which is that there is research
showing that when people are more connected to nature, that
they're more likely to protect it.
And it makes a lot of sense because you pretend what you
love. But they also engage in
behaviors and adopt values aboveand beyond conservation.

(54:19):
They tend to recycle more and save more energy and vote for
climate advocates. So from a little kid who who
would give speeches about the disappearing rainforest and be
called a tree hugger by my family, to to an adult who's
heading up a big physicians environmental organization and
running a national nature prescription program, I think

(54:41):
that really holds true for myself.
I really felt connected to nature when I was a kid and it's
it's become beautiful things as an adult.
Doctor Lim, thank you, you know,for taking your time and for
being here on the show. My pleasure, Yelis.
Thank you so much for inviting me.
I had a great time talking with you.
All right, and that concludes this episode with Doctor Melissa

(55:05):
Lam. I truly hope that you enjoyed it
as much as I did talking to Doctor Lam.
Now, to find any of the resources mentioned by Doctor
Lam, check out the show notes which are, as always, located in
the description of these episodes.
Or if you can't find them there,you can also go directly to the
IPS Project dot podcast and search for Doctor Lam and the

(55:29):
episode will pop up with that. Thank you so much once again for
being here and who knows, maybe I get to welcome you again soon
on another episode here on the IPS podcast.
Until then, this is your host Yellis, fast signing off before
you take off, if you already feel like you've gained many

(55:50):
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(56:12):
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The Healing Power of Nature | Meet Dr. Melissa Lem, The Doctor Who Prescribes Nature

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.css-14f5ked{margin:0;word-break:break-word;display:-webkit-box;-webkit-box-orient:vertical;box-orient:vertical;-webkit-line-clamp:2;overflow:hidden;}The Healing Power of Nature | Meet Dr. Melissa Lem, The Doctor Who Prescribes Nature