There is abundant medical literature advocating the treatment of the whole person. Perhaps there is a basis for arguing that individuals are inseparable from their environments, that for them to be healthy over the long-run their environment must be healthful. The manager-controller mentality leaps to the assumption that healthful relations can be encouraged or created. My premise is generally: (a) that full humanity can only be achieved in a stable, growing environment, (b) that healthful people are positively disposed toward tending and enhancing an environment in which they live and on which they depend, and (c) that healthful environments provide opportunities for recovering, building, and discovering the full self.

These not-very-profound and somewhat abstract concepts need to be transformed into operation. They can be with much work, creative investment, and new concepts and knowledge about the interactions between people, especially youth, and their environment. I work with these ideas by the fire at Peculiar Manor and on the porch watching the autumn Fort Lewis mountain change colors. The ideas are challenging because on one hand, they are intuitively correct, on the other they beg for proof of practice, a kind of sensory pragmatism. I would like to implement these ideas, perhaps at Peculiar Manor, but that is my personal peculiar dialectic. I see them so clearly and am so convinced of their rightness, that they need to development, no proof. There is nothing more needed, only time and talent - both in short supply. There are research topics, of course, but when 80 percent solutions are available, there is no time to deny the solution. The future lies in adjustments and refinements under the conservative inductivist.

Architects are prone to discuss the rapid recovery of patients in favorable hospital environments. Such literature, also that of conservation education, and the newer literature (post-1969) on environmental education, and empirical evidence can be used to build a theory of the role of the outdoor environment in patient treatment.

In the same way that a doctor prescribes hospital rest or a pill, it would seem feasible, with more knowledge of cause-effect relations, to prescribe from a large set of situations and activities such as those listed in this paper. "Fresh air and exercise" are old prescriptions, but they can be made more specific for specific maladies and specific individuals.

Each patient has special needs. By having a large set of optional therapeutic resources, a doctor can use these in many permutations (not just combinations, but sequences). A simple computation may be instructive. The question is: How many permutations are there that a doctor (or staff) may prescribe, given a set of 30 "things," tactics, or treatments? The answer is 2.6 x 1032 (remember that 1 x 109 is a billion). The odds are great that (1) several strategies can achieve the same end result, (2) that choosing "the" right solution is difficult and may be impossible without assistance, and (3) there will be more than 30 optional treatments available to the doctor. The trick is to create a unique treatment (a set of activities) to match the unique individual. No effort is made here to address specifically the critical emotional, family, physio-pathological, and spiritual dimensions of a patient or patient-group. All of these are believed to be best addressed interactively but in this chapter only a few are addressed.

From the following, I envision a computer giving a doctor, on request, responses to questions like:

1. What opportunities exist for burning x calories per day of body energy?
2. What practices are currently operational for building confidence, peer-relations, and independence?
3. What practices are there to encourage creative expression, rapid weight loss or gain, and muscular development?
4. What tactile enhancements are available?
5. What opportunities are available to improve lower-leg (etc.) strength?
6. What puzzle solving is available?
7. What new opportunities are available for teaching effectively conventional, basic school topics?

Cross listing for such a set of questions may include refinements or selections by disease, age, sex and perceived socioeconomic class. A clinical record of use, rejection, successes, and failures may be kept as cumulative feedback from a large group of patients over time.

The ideas for doing the above follow in no particular order for they might be available in a new hospital/environment relationship, probably in a computer "catalog," and a doctor would select a unique set for each situation. The needs are to have available the widest range and largest number of therapeutic facilities and opportunities available for unique patients who need unique prescriptions. Average prescriptions are now relevant only to historical discussions - for patients or for places in the land (as within a concept of land health). Abundance-of-use may be one criterion for suitable techniques or therapies in some situations but having the one facility or "unit" available for the one or two patients that are in critical life-need seems to justify the idea of making many facilities available.

Ideas

A. Mark a tree (telling why), fell it, have the group load it on a truck, take it to a local saw mill, watch it sawn, take wood to a dry rack, replace dry with green wood, use dry wood to build owl, squirrel, wood duck, or goldeneye boxes, and have the group put them up.

B. Make in a local shop a special fence post with included bird house in the top. All posts should be of this type, using local wood, preserved, each a personal post, each contributing to birds, and holding fence wire. Maybe they can be sold as a craft item from the youth who care to (or need to) make money from honest, physical, useful work.

C.Establish plots for tree thinning. Mark them with a big number on a locust post. Students can help thin and know what was "their" plot. A record should be kept so when they return to the area as adults, they can see their work.

D.Create a bird watching trail with habitats enhanced in some areas, blinds built in some areas.

E.Develop a tide-driven or stream water-wheel to provide electric power for various uses. One would be to power a small light over a marsh or water area so observers can see bats and birds feeding at night on the insects attracted. Fish and other creatures could be observed and nature studies conducted (seasonal behavior, relations of time and temperature, species richness over the seasons, etc.).

F.Create a diverse set of recreational opportunities. There may be needs for classical local sports, but a diverse set of unknown and unusual sports can be created. I recommend that emphases on classical sports be on improving skills, like having an automatic batting machine to speed up the processes of self-learning, or to have coached batting improvement; a pitching target with a bowling-ball-like gravity-return to speed up the learning (the pitches per unit time); a volley ball court in which over-the-net balls are "cascaded" on to the player to speed up net behavior (or rear-court behavior). Even a cross-net serving target could be set up - again to speed learning and physical development.

The emphasis is not on speed per se but on changed personal behavior and physiological and anatomical processes per unit time and cost, given other constraints (like minimum muscular pain, etc. and "real" playing time). Personal success is important, but ability to succeed in groups is also needed.

Recreation

The area may be the point of origin of a new spirit of recreational participation for all ages. Spectator sports may be included but de-emphasized. The assumption is that precious land is utilized for only occasional use by a few people in baseball and football, and areas for such sports are available in many places. In the therapeutic environment, recreation is for everyone. It should be creative, diverse, and compatible with the area and its users. The recreational personality of the area need to be conspicuous to all who visit. It may start with the initial contacts and "density" of contacts as the area is approached on the first visit. Perhaps electric powered or horse-drawn buses taking visitors from a remote parking area, should be open (like San Francisco trolley cars) with bells and pendants. They might have a funny horn and "speak" to passing buses with a pleasantness that will delight children (and parents and others who watch their eyes).

There should be flags, mostly small ones, and flag poles. There may be a low key, high quality carnival atmosphere to be created. A medieval joust should fit right in (though it is not recommended). There should be nothing over which children may trip and parents should relax as children run. Children should want to run and climb (and adults too). Entrances and exits must be given special architectural and landscaping attention.

The areas and activities that may be developed include (in no particular order):

1. Stone throwing area (1, 5, 10, 20 pounds)
2. Spear throwing areas (distance and accuracy)
3. Rock throwing range (a) vertical accuracy; (b) horizontal accuracy (each with points)
4. Sling shot range
5. Frisbee field with targets and games
6. Archery range
7. Beam walking area with progressively higher and more narrow beams
8. Tight-rope walking (6 inches, 1 ft., 3 ft. with sawdust pit)
9. Massive checkers - 5-foot log pins, 6-inch diameter - to be moved from holes in the center
of white and red cedar chips that make up the playing board 10. Jogging trails with exercise spots along the way (bars for pull-ups, culverts to go through, ropes to climb, push-up suggested, ladder to climb, etc.)
11. Rope jumping area
12. Hayrides
13. Bus or truck tours with lunches
14. Sleigh pulling area (harnesses for sleighs with increasing stone loads on sleighs)
15. Nature trails
16. Challenge area. This will have a spectator area for occasionally there should be a "meet" or challenge. Elaborated obstacle course with divergent pathways for children, adults, and elderly. Perhaps a "3-ring" area so all can compete
17. Official horseshoe court
18. Lawn bowling court (with local rules)
19. Kite flying contests
20. Marble shooting range
21. Elaborate children- and adult-play-areas with swings, slides, climbing areas, ropes, rope swings
22. Giant ball games, tug of war area, sack race areas, and unusual creative games 23. Rope climbing tripods 24. Sculptured earth for running on an angle, rolling, and playing "king-of-the-hill" 25. Person-size puzzle areas (6) (e.g., how to get from A to B using only equipment provided)
26. Ice-skating pond (add lights for night-time use)
27. Foot-race track
28. Soccer (local rules)
29. Rich photography opportunities
30. A cross-country ski course should be considered and integrated with trail system
31. Special blinds for wildlife observation and photography. Special baits and scents will be required to initiate and maintain wildlife use (bear, bobcat, turkey, deer, songbirds)
32. Trails for special people (handicapped) should be prepared
33. In special quiet areas, a chess table and stools should be provided
34. Tutoring in elementary mountain or rock climbing can be considered, depending on staff and interest.

Perhaps horses can be tied into special sporting events such as tug of war. Shower house, clothing check area, drinking water, and toilets will be required. Waste water and solid waste may be recycled. Liability must be evaluated carefully. Bicycles and racks may be provided. Tutoring in elementary mountain or rock climbing can be considered, depending on staff, and interests, and liability analyses.

Scheduled events at least monthly on weekends may help assure local contacts and more full use of area. These include:

1. Forestry field days
2. Dog shows
3. Archery meet
4. Cross country race
5. Fiddler convention
6. Coon dog race (timed on a scent trail)
7. Special hunting dog field trials
8. Horse shows
9. Scout days
10. Handicraft shows (carvings, pottery, etc.)
11. Country dancing
12. Lectures
13. Power saw expert show
14. "Name" entertainers
15. Equipment shows
16. Frisbee tournament
17. Barbecue
18. Summer theater in the round
19. Old-gun shows
20. Fox fire demonstrations (weaving, apple butter, etc.)
21. Hog calling
22. Frog jumping contest
23. Tournaments for the handicapped
24. Field days for the elderly
25. Photo contests from the county

Although creativity is encouraged, a regular annual schedule of events should be created.

All of these may be integrated with adult camping, youth camping, and educational programs.

Complex Programs

A goat or pig unit may be developed as a center of activity, a means to get patient-animal, then patient-to-patient interactions and to learn, secondarily, concepts such as those of parenting, responsibility, cost effectiveness, and maintenance. The operation can be break-even or, even if at a financial loss, can be viewed as an almost essential therapeutic "device."

Within the following set of ideas for facilities or in some association with them, the following types of activities seem well worth considering. They will differ by characteristics of and objectives for an area:

1. A board walk over wet areas will be invaluable for getting watchers and others "back in" without a need for boats, etc.
2. Duck nest sites can be created, partially by muskrat management.
3. Osprey and eagle nest sites (tripods with a top) can be built in a marsh with impressive payoffs.
4. Observation platform(s) overlooking a marsh (with binocular and telescope rests) will probably be in demand.
5. Live trapping of various creatures can be encouraged for research, animal study, and marking.
6. Trot lines for fishing can be fun for kids.
7. Create next to a fox or woodchuck den a wall so people can open doors and see inside the den at eye level (a 3-D den).
8. Burn over or fertilize a plot (e.g., 10 x 10 ft. or 40 x 40) and study its ecology and succession as it revegetates.
9. Create a triangular field layout to produce "corners," thus quail and other field game and song birds.
10. Make 5-20 tracking "pits" or small areas 3-5 feet in radius. These can be near roads or along a nature trail. Cover with a sand-clay mix so tracks show up well. Counts made from them will help find out what animals are prowling, what population changes various activities are causing, and give indices to population trends in wild animals. A post in the middle with some lure will make these areas very "busy."
11. Hold treasure hunts. These hunts are especially good techniques for learning as well as testing what has been learned.
12. Conduct tree identification contests, have some trails for instruction, others for tests.
13. Have catering done in blinds. At certain periods and for certain clients, it might be possible to have "catered blinds," services for people who want to relax, look, experience the marsh and forest (and avoid any problems).

The possibilities of a computer system for the following can be useful in many ways:

1. Record car visits.
2. Compute user days spent on the area.
3. Relate distances traveled to willingness to pay to see and benefit from the area or activities.
4. Make account records for clients.
5. Keep tax records.
6. Project likely needs.
7. Form psychological profiles of users.
8. Plot research income.
9. Compute and plots efficiency indices relative to goals.
10. Generate probabilistic user profiles.
11. Produce computer maps of the area's soil, archaeology, wildlife, camping sites, roads, trails, etc.
12. Generate land use prescriptions.
13. Compute various indices of land efficiency for achieving certain goals.
14. Do intra-organization analyses (sociograms, links, information flow, etc.).
15. Do county analyses (homes of the users and the environmental factors that influenced them).
16. Do network analysis and the concept of the users in a serving line and the most efficient pathways to assure a "good" final product - a satisfied, well, or healthy person at some point in time.
17. Conduct specialized library searching services.
18. Make mailing lists (extension, bills, publications, meeting notices, news releases, camping literature).
19. Do budget planning.
20. Produce dynamic documents , i.e., current state-of-the-art documents as perceived by the staff at a point in time on a select range of problems. This is a computer-stored staff-written book that captures the best ideas and information available and dynamically preserves that for all future staff. It prevents loss of knowledge when a staff person dies, retires, or is employed elsewhere. It has the characteristics of a giant newspaper, a throw-away. It is a system that can produce a document that is constantly edited, revised and updated, but never completely "retyped."
21. Demonstrate to visitors for sale (or gifts) computer software that can be used in other areas.
22. Schedule maintenance and feedback to all components and aspects of the system.

Such a facility could become the impetus for a youth health movement. It would attempt to achieve what I think is missing in health care delivery - personal incentives. There might emerge the concept of "The Youth." Such a person could be a member for a small membership fee. They could be moved through 10-20 health status stages. A computer could be used to record their entrance, characteristics, progress. There could be provided a magazine, quarterly mailings of a personal health status based on sex, age, weight, genetics, past medical history, family position, diet, questionnaires, etc. The movement is a concept of personal, dynamic, public health with feedback to allow (and encourage) youths to achieve levels of health, safety, physical fitness, etc. likely to accompany them through life. "Youth" may graduate to a higher group. The incentives are personal security (through self-knowledge), competition with self (the stages) and others, insurance rate incentives (for them or their families), meetings, annual conferences, periodic news releases of healthy youths, trips, camping opportunities, etc. This may be tied with sports, but I think it is possible to create a "sport of healthful living.

Computer capability exists for aiding with, allowing the above to be possible. It will take an "outreach" staff, but with a core cadre and abundant use of known and developing knowledge, youths might benefit significantly. The movement should not become project- or meeting- or club-oriented. It should be very personal, a relationship between the main office and the individual, with the computer in the middle to aid in communicating to the mass on a pseudo-personal basis. The resulting data base on thousands of youths should be of great value to researchers and feedback to individuals. Stages might include:

1. Enrollment and initial data
2. Completion of a questionnaire and basic very easy tests or data entry, height, weight, etc.
3. Completion of more elaborate questionnaire and perhaps some sample (such as urine)
4. Completion of a machine-graded diet knowledge test (administered by teacher)
5. Completion of a first aid and basic how-to-get-well test
6. Completion of an advanced questionnaire about self
7. Completion of an advanced personal health test (to include part of III and V and achievement of at least 5 out of 10 health indices)
8. Achievement of at least 7 out of 10 health indices
9. Participation in a health-related project with hospital, laboratory, elderly achievement of 8 out of 10 health indices
10. Completion of a test on environmental health achievement of 9 out of 10 health indices. Achievement of advanced stages may be announced at special award ceremonies, camp fellowships awarded, etc. A very large alumni body, patients and parents, may help build long-term support and improvements.