Unexpected readings: looking for beauty in books at the Veneto Institute of Oncology

Hospices are specialized facilities for palliative care. With the purpose of improving the quality of life and making the Veneto Institute of Oncology (IOV, Padua, Italy) a more reassuring and less impersonal place, the Scientific Library has designed a project called “Letture inattese” (Unexpected readings) that brings books to guests, carers and the health workforce of the Hospice. With people in mind, rather than their illness, this project aims to generate a moment of wonderment, relief and recreation through the beauty that can be found in books. This first non-scientific patients’ library at IOV intends to create opportunities for deepening the quality of human relationships between the patients, their families and the healthcare professionals

Unexpected readings: looking for beauty in books IOV has a Scientific Library, specialized in health information about oncology and related biomedical sciences, that works mainly with researchers providing support in different stages of their work, ranging from bibliographic searches to intellectual property consulting. The Library also manages and reports the yearly institute's scientific production to the Italian Ministry of Health. All bibliographic material is digital and related to oncological scientific research. During the COVID-19 pandemic, working in a physically isolated mode, far from the hospital and the research laboratories, limiting visits and meeting online with collaborators, a craving for connection with the community was starting to arise in the Library. Thinking a lot about people, having them in mind rather than their illness or health situation, there was a growing interest in the concept of humanization of care (1). Recognizing the importance of social connection between patients, healthcare workforce, caregivers, visitors, and society at large, we were reflecting on how to address the need for empathy, leisure and being in the present moment at the Hospital. As librarians, we had books in our minds. As early as 2000, the International Federation of Library Associations (IFLA) Guidelines for libraries serving hospital patients and the elderly and disabled in long-term care facilities had indicated how "books, reading, and library materials can exert a positive effect on the state or recovery of those who are physically or mentally ill" (2). Moreover, scientific literature about bibliotherapy and the impact of reading on mental health was giving us evidence about the relevance and the role that literature (fiction and poetry) could play in supporting people in hospital settings (3)(4)(5)(6). Acknowledging that books can limit the sense of isolation that patients and the healthcare staff may feel during hospitalization, we designed a project aimed at bringing them to the hospital wards at IOV. The challenge to start this new patients' library during COVID-19 pandemic, with a specially fragile population as ideal beneficiary, was to plan a book loan procedure that could be done in accordance with the national guidelines to contain the risk of Coronavirus infection. According to a 2020 document issued by the Istituto Centrale per la Patologia degli Archivi e del Libro (7), which deals with the management of sanitization and disinfection of archives and libraries, consulted materials had to be kept in isolation for at least 10 days after being manipulated (reduced to 7 days on subsequent update of the Guidelines on May 2020). Within this context, we developed the project Unexpected readings considering the need to limit manipulation of the books while also creating a moment of wonderment and surprise. Coincidentally, at the time the project was being designed, a newsletter from the Veneto Region informed us of an open call for museums, archives and libraries, to apply for regional funding for the growth and enhancement of cultural services of the territory (8).
To apply, the proposal had to be non-profit, with a regional if not national cultural impact. The project was submitted in June 2021, and received positive feedback in October the same year; it was granted funds for the purchase of the books. Being a pilot project with limited resources and in need of a concrete and relatively small venue, the Hospice was chosen as the place to host Unexpected readings; book loans officially started on April 26, 2022.

Unexpected readings at the Hospice
The Hospice of the Veneto Institute of Oncology is named in memory of Dr. Leopoldo Celegon, a cardiologist who spent his life helping and relieving people in pain. Its mission is to provide palliative care focusing on patients' needs, values and expectations. It has six bedrooms and some common spaces, where guests can be accompanied by their familiars and friends, day and night. There is also a particular room called "room of silence" (stanza del silenzio), a neutral place of quiet, inclusive and cross-cultural, where whoever can think, pray, meditate, look into their interiority. The spacious common lounge, at the entrance of the Hospice, is particularly cosy and full of light, thanks to the wide window overlooking the delightful Villa Parco Bolasco's garden. In this room, people can find Unexpected readings and a poster with instructions on how to participate in the project. The Hospice's healthcare personnel kindly integrate the library operations in their daily medical routine (Figures 1 and 2). This is how Unexpected readings works: circa 300 books were collected and divided into 5 themes or categories. Each theme has 50 different books, of various literary genres: novels, poetry books, short stories, illustrated books, graphic novels, essays and travel books. People who want to read something do not choose a Giuliana Prevedello, Valentina Bozzato and Marianna Gnoato book but a theme: the personnel at the Hospice will give them a fabric bag with five unexpected volumes (each one related to the category that was chosen, but a complete surprise for the reader). The books are on loan, the bag is a gift. When books are returned, they are left in quarantine before they are given to somebody else. To choose the five themes that hold together the book collection, we let our mind wonder and imagined we were perceiving the whole existence in just a glance, from the immensity of the cosmos to the most ephemeral yet important life, like the one of an insect. Each theme has a corresponding color and a title: the blue one is The stars, the universe and everything (a wink to the third book by Douglas Adams' Hitchhiker's Guide to the Galaxy) and it collects books about the cosmos, the ancient geological eras and philosophy; the green theme is Chlorophyll and oxygen with illustrated books about eye-catching botanical images and wild animals as well as novels that explore uncharted territories, mountains, lakes and woods; the yellow theme is Colors and black and white all about creativity, art, photography, design and architecture; the red section holds literature about adventures, hidden treasures, words shining between vivid images and its title is It was a pleasure to burn (a quote from the incipit of Fahrenheit 451, Ray Bradbury's science fiction novel). Finally, the violet theme Back and forth in the world, suggested by the Hospice nursing personnel, is a collection of images and stories from places far away or really close, to expand the space of one's boundaries. We thought that through these five themes, books could provide a sense of connection with the outside, while creating some space for the exploration of the inside. We chose each book carefully and with a lot of love, looking for beauty inside of them. They not only had to fit within a certain theme, but also had to meet certain requirements: volumes had to be comfortable to handle, easy to hold and leaf through. Novels could not be too long or too depressing. The selection was driven by an impulse to look for beauty and wonderment inside of books. Banal or gloomy books were excluded as well as all material regarding oncology or health related issues. Nevertheless, during our meetings with the Hospital Psychology Department, the need to address spiritual and thanatological issues was also considered as a possible future integration of this project. We searched for ideas in bookstores, in our houses and we asked our friends for suggestions of interesting books to include in the collection. Guests, visitors and staff of the Hospice, colleagues and local writers all  suggested some titles, and so did the booksellers of the two independent bookstores, "Limerick" and "Zabarella" of Padua, that we engaged with.
Finally, to answer a specific request from the Hospice staff, a little collection of playful illustrated books for children and teens was also acquired and placed in the small kid's corner at the Hospice to also give patients' children the opportunity to read and wonder.

The importance of senses
We tried to consider the role that different senses could play in the way the project could be perceived through touch, sight and hearing. To preserve the texture and sensorial quality of the book covers, none of the volumes were laminated with plastic. To provide access to literature through hearing, even for those guests with decreased levels of consciousness or motility, each room will be supplied with a tablet and a collection of audiobooks.
To make the whole project visually stimulating, we designed a logo that is printed on the fabric bags that are gifted to people. The drawing ˗ an open book resembling a flower ˗ was inspired by the beauty that can be found at the Padua Botanical Garden, where nature blooms all year long marvelling at the unsuspicious winter visitors. In line with this idea of wonderment, the first aim of the project is to create a moment of surprise, kindness, relief and ease through the beauty that can be found in books (Figure 3).

Conclusion and future perspectives
With Unexpected readings, the seed for a non-scientific patients' library was planted at IOV. With it, the intention to address those needs that patients and healthcare workforce in an Hospital may have, that go beyond the relief that drug treatment can provide. To investigate the impact that this project may have, an evaluation form was designed in collaboration with colleagues of the Scientific Directorate support offices. The feedback that will be collected with this survey will provide a guide for future perspectives. Moreover, the Library is now starting to engage in an exploration of the Italian territory to discover hospice patient libraries, opening up an opportunity to create a network of shared experiences. Different departments and units at IOV Hospital are eager to provide exposure to literature for their pa-tients: the project is already reaching patients and visitors of the Common Ward for Medical Oncology, next door to the Hospice. This generated the need for a bigger book collection and more personnel in charge of managing and mediating the project. A program of read-aloud sessions in the hospital wards may provide a connection between the health community and the local authors that are featured in the new patients' library.
In conclusion, Unexpected readings aims to create a moment wonderment thanks to the surprise of unexpected books (since the dynamic of accessing the book collection is done through the choice of a theme and not of a book title); a gesture of kindness with the gift of each bag; and a breath of relief and ease through the beauty that can be found in novels, illustrations and poetry. Unexpected readings intends to build opportunities for deepening the quality of human relationships in an environment and in a time of life very sensitive, not only for the patient but for all people around. Reading can help patients and the healthcare staff to humanely connect during hospitalization.

Giuliana Prevedello, Valentina Bozzato and Marianna Gnoato
Maybe the space of the Hospice feels different with the presence of books, a bit more comfortable and inspiring, a little more like home.

Funding
This project was funded by the Veneto Region (LR n. 50/1984, art. 44).