A three-eared rabbit stands on Bridgette Czarnecki's hospital bed. He playfully wiggles his ear and adjusts his yellow bow tie.
"You're stronger than you know," he tells the 8-year-old. "I wish I was that strong."
A flying pink-haired cow swoops in, pirouetting in the air. "Believe in yourself," she says in a gentle voice. "I sure do."
Nearby a friendly green monster smiles and waves. "Never give up, kid. Never give up."
They're all part of the Imaginary Friend Society, and they are exactly as billed: a figment of the imagination. For Czarnecki, who was diagnosed with a brain tumor in November, they were a welcome distraction from the stress and anxiety of MRIs and chemotherapy while she was treated at the Children's Hospital Los Angeles through February.
Czarnecki summoned the characters from a touchscreen above her hospital bed and the Imaginary Friend Society app developed by the Pediatric Brain Tumor Foundation. The app uses augmented reality, which overlays digital images on top of what you're seeing in real world.
"It makes me feel happy," Czarnecki tells me.
Augmented and virtual reality are increasingly entering the world of health care. VR has been used for decades to help people overcome phobias and anxiety disorders. As the equipment becomes sleeker and cheaper, it's being rolled out in more settings, from training midwives to helping stroke victims regain motor function. A growing number of researchers and hospitals are also finding the technologies can reduce patients' anxiety and pain.
AR may prove especially helpful for young cancer patients, who feel as if the cow, rabbit and green monster are in the hospital room with them.
"There's power to [them] being in your room versus on a screen," says Jason Sperling, creative development chief at ad agency RPA, which helped create the AR app. "They feel more real."
So real, in fact, that when kids use the app for the first time, they often lift their iPadto see if the characters are really there, he says. Patients can use the free app on an iPad, iPhone or hospital touchscreen. They can scroll through a list of a dozen or so characters and place them anywhere in the room.
Tapping on a character prompts it to share words of encouragement.
A needed escape Nobody likes being in a hospital, which can be especially scary for young cancer patients going through a painful barrage of injections, chemotherapy, MRIs and other treatments that assault the senses.
AR provides a valuable distraction that engages kids' imagination while reducing anxiety. That's a huge benefit; 76 percent of adults surveyed by the Pediatric Brain Tumor Foundation said young patients are scared and anxious. Additionally, 70 percent of the respondents say there aren't enough tools and resources geared specifically for kids.
"It's so tough what these kids are going through and what their families are going through," said Dr. Mark Krieger, chief of neurosurgery at Children's Hospital Los Angeles. "To have something that can let them smile and laugh and feel in control really changes things."
Novel technology The Imaginary Friend Society AR app is used in dozens of hospitals and cancer treatment centers across the US, including the Children's Hospital of Philadelphia, Children's Healthcare of Atlanta and the Dana-Farber Cancer Institute.
Part of the appeal of the technology is its novelty, says Kathleen Chen, assistant professor of pediatrics and anesthesiology at Baylor College of Medicine.
"VR and AR are unfamiliar to a lot of kids because they're such new technologies, so it's instantly engaging and very distracting," Chen said. "It minimizes any focus on the negative experience that they're actually having."
But there can be a downside: With their wild imaginations, kids can have trouble separating the virtual world from the real one, Chen said. For that reason, violent content is a no-no, while positive messages are a plus.
For Czarnecki, who finished chemo in February, the AR app provided a healthy injection of joy into an otherwise harsh reality, said her father, Jeremy.
"It sort of just takes the mind off of everything that's going on."