NICU nurses are not angels

NICU nurses aren’t angels. I told them that they were, of course. I told them as if my life depended on it, even though it was my boy who really needed them. But even then, even when all I could do was to repeat how grateful I was, how I thought they were incredible, as if somehow if I were the politest person on the planet then that would make everything different and better, I noticed their reaction, the slightly awkward shuffle and deeply sincere “thank you” as they glanced among each other and tried not to roll their eyes. They weren’t being unkind, of course, more just slightly jaded, waiting for this next set of dazed and bemused parents to catch up and settle in.

As I spent more time there, I saw the same scene unfurl over and again. The terrified parents, the shuffling, pain-racked, hormone-crazed mothers and the gray-faced, stooped but still slightly defiant dads, blinking into a new reality that hadn’t been possible only days before. A new, neon-lit terrordome, filled with tiny bodies and enormous equipment, where the line between life and death wasn’t even the breadth of a hair.

We had the sickest baby in the NICU. I’m all for awards, but this was one accolade I could have done without. And it seemed impossible when we saw the other tiny creatures lying, catatonic in their hot boxes. Ours wasn’t so tiny. He was twice the size of most of them. Yet there we were, learning a whole new language and meeting new people for whom this little life was an excellent challenge. And that’s when you realize that NICU nurses and doctors aren’t angels. They’re just people. Highly trained, incredibly skilled, often wonderful, infinitely patient people. Yet science is an art, and only some doctors are da Vinci.

And how funny and curious that this alien environment turns out to be more familiar than we laypeople could ever have imagined. Group dynamics still apply, and some professionals play better than others. The NICU’s a stage like any other, and not everyone remembers that they’re on parent cam at all times. Those who ran, giddy, when a code was sounded, a siren call beckoning them to come revive a poor baby who’d forgotten how to breathe, didn’t know that this terrified parent was watching them laugh as they sprinted down the corridor. But I was. The resident chewing gum during rounds didn’t know that I wanted to cause her bodily harm to make her shut her goddamned mouth. But I did. The nurse who scrounged a rocking chair when I could finally hold my tiny son didn’t do it for gratitude but because she thought it would be more comfortable. And it was. The doctor who spent hours answering the same questions again and again, never faltering as I continued to fail to understand how the answer could be “we just don’t know” herself didn’t know how helpful this repetition treatment was.

And none of them had any idea that the best thing of all was when they stopped showing up. When the crowds who’d throng during rounds to pore over X-rays or argue about medicines slowly thinned out as the boy got better and less interesting, leaving only the residents who had to be there and the nurses who were always there. That was the best of all. I love those nurses for being there then, and while they might not be angels, they’ll always be my heroes.

[[Note: I just found this file on my desktop. It’s dated November 7th, 2014, when we were happily home from the NICU and my son was nearly three months old. I have absolutely no recollection of writing it, but it feels right so I thought I’d put it up here.]]

Find me at TED …

Someone pointed out that it’s super ominous to have the last post on a website be “Design-related musings on a hospital stay” … dated back some years ago. Design-related or not, this apparently leads people to think you might not have made it to the here and now … So I’m happy to report that I am very much live and absolutely fine, thanks for worrying. Find me over at, where I’m working with wonderful writers and generally focusing on them — and, tbh, my beautiful baby son. Updates here few and far between but please do reach out to say hi etc. xoxo

Design-related musings prompted by a hospital stay

A couple of weeks ago I went to hospital in NYC, where I had abdominal surgery to remove apple-sized fibroids from my uterus. A totally innocuous operation, it turns out (so many women I’ve spoken to have either had fibroids themselves, or know someone who has them). But it was my first ever stay in a hospital, and my first ever surgery, and now I’m laid up at home recovering, getting more and more bored by the day. As I regain my strength, I find myself mulling some design-related thoughts–and questions about the healthcare system I haven’t been able to answer. So, purely as personal therapy, here goes nothing.

1. Physical includes mental wellbeing.

When my doctor informed me I’d have to have surgery, she spent about five minutes going through the potential risks, from a perforated bladder to a damaged liver, or was it kidneys? I can’t remember, because at some point during the list I burst into tears and couldn’t take it all in. “There, there,” she said. “I have to tell you these things.” Right before the operation itself, the anesthetist had the same shtick, a focus on describing all the things that might go wrong, the potential pneumonia, etc. I totally understand that they didn’t want me to sue them if anything had gone awry, also that I absolutely need to be an informed patient. But walking into the operating room felt like walking to the gallows. I was petrified. And I can’t help but think that this isn’t exactly the right state of mind in which to go under the knife. After the operation was over I was asked about a heart arrhythmia that had cropped up during the procedure. I wanted to reply, “I’m not SURPRISED my heart was all over the place, goddammit!” though I went with the rather less rude “um, dunno.” What better ways can the system inform patients while allowing them to retain a positive state of mind when they’re going under the knife?

2. The critical importance of floor design. 

I confess I hadn’t really paid much mind to floor design before, but now it’s become an obsession. Being wheeled from recovery through the hospital to the ward was an exercise in torture. (Admittedly, this was all playing out at NYU Langone, recently reopened after Sandy shut it down, so I will allow that this means a lot of temporary surfaces as they get back up to full speed.) But even in my morphine-addled state, being bundled into one elevator before being wheeled across the front foyer of the building (itself, frankly, an indignity) in order to access a separate bank of elevators to get to the ward was utter agony. The bumps, jolts, and grates of the journey seared right through the drugs, leading to bursts of expletives from me that freaked out fellow travelers I don’t think were expecting the pale corpse to be interactive. There really isn’t some way to design some kind of ramp from one side of the elevator to the other to guarantee smooth entry and exit? When you’re held together by tape, being bumped about is approximately the worst thing imaginable. And a pox on multi-textured floors that exist for no apparent reason other than aesthetics. Ouch.

2b. How (not) to get from gurney to bed. 

“Use your elbows,” I was instructed, as three nurses attempted to get me off the surgical gurney and into my more permanent bed. “Are you fucking kidding me?” I think I replied, before I burst into tears again, stuck half way between the two and feeling like I might literally fall apart at the seams. Isn’t there a better way of transferring people from one to another? The nurses were nice, but I felt them looking at me like I was a crazy person, while I felt like a fish flailing on land. Awful.

3. Interaction design for dummies.

All sorts of amenities are available from a hospital bed. There’s a television that swings around as needed, there’s a call button, there’s a personal light. And I didn’t know how to work any of them. Now admittedly, I was impaired. (Morphine, man. It sure is effective.) But at no point did anyone tell me how to access or operate any of these pieces of equipment. I didn’t even know I had a call button until a nurse pulled the cord off the floor and handed it to me. That went badly later when I promptly dropped it, and had no way to alert anyone that I’d done so (or bend over to pick it up). I also had no idea that when I pressed it, I should be prepared to answer to the disembodied voice of someone answering from who knows where. So for the first day or so I likely pissed off my new protectors something rotten by pressing the button and ignoring the voice that tinned in my ear. Not that I felt like watching it, but I never figured out how to work the television. As for the light system, it was a joke. “Pull the red cord three times,” instructed one doctor who came to visit in the middle of the night. “Three times?” I asked blearily. “Yes, once to activate the thingy, then to, I’m not sure. Then to turn it on,” she replied as she yanked three times on a wire loosely attached to the bed’s headboard. The system was essentially jury-rigged so a patient or doctor can operate the wall switch from the bed. The system was unbelievably badly designed.

4. Acronyms and titles, oh my.

Every person who came into my ward was courteous to a fault, introducing him or herself to me and being sweet, kind, and professional. Nonetheless, I had no idea what 90% of those people were up to. (Except for the guy who came to buff the floor. I knew what he was up to, and I am still incredulous that floor buffing is a practice that happens while immobile patients are lying there.) Each person seemed to have a very official sounding title, and I’m sure that said titles are extremely useful in the internal world of hospital bureaucracy. They are meaningless and confusing to the bleary patient lying in bed. I suppose it doesn’t really matter that I couldn’t distinguish a “registered nurse” from a “patient care technician,” the two who seemed to shoulder the burden of my care, but it’s safe to say that being in a hospital bed is a vulnerable experience. Might have been nice to have some sense of who the hell all these people were. Not least because I’d like to apologize for all my absolute foul-mouthed language as I embarked on my convalescence. What can I say? I blame the morphine.

A love note to Twitter

I have an essay in Matt May‘s upcoming book, The Laws of Subtraction: 6 Simple Rules For Winning In The Age Of Excess Everything, which will be published by McGraw-Hill in October. I’m looking forward to seeing the final book; for now, MM gave me permission to feature my short essay, a love note of sorts to Twitter.

The first time I saw Twitter being used in the wild was a strange experience. It was 2007. I sat next to a guy I knew in the auditorium of a conference and watched, confused, as he tapped into his laptop: “Sitting with Helen Walters from BusinessWeek.” Why is that interesting? I asked him. “It’s not, really,” he answered, shrugging. So I gave him what I hoped was my most withering look and then turned my attention to the stage to focus on writing and reporting in the traditional way I had long understood.

Since then I’ve come to appreciate the 140-character medium. Twitter seems to embody the essence of subtraction. The brevity forces you to focus on what’s truly important and to harness the restrictions as a challenge. The exercise of paring down meaning and insight into its purest form, formerly the purview of headline writers and the copy desk, is an invaluable one for anyone looking to communicate in the modern world. Such focused, clear thinking feeds back into the writing and thinking of a longer article, too.

In the years since I signed up for the service (in 2008, still reluctant, still grumpy, quickly addicted) I have marveled at the way in which this simple service has aided my writing, my thinking, my network, and my life. Many people seem to have constructed complex theories about the best ways to use it. My own philosophy aims to ape the simplicity of the service itself: don’t overthink things. I tune in when I can; I write what I think; I engage with those I feel are real; I don’t sweat the number of people following me; and I don’t talk about what I had for lunch unless it was genuinely remarkable.

As the years have passed, the service has created new relationships, strengthened old ones, given me space to think aloud and to ask for feedback or critique. (And boy, do people deliver.) I have watched breaking news stories unfold; I have cried over updates from people I’ve never met; I’ve been guided to stories I would never have seen; and I’ve been introduced to incredible people I’d never have known were it not for this powerful yet brilliantly simple form of expression. 

I know that many people still don’t get Twitter and there’s certainly still time for the company to take a wrong turn, to pollute its purity with some bad business decisions. But for me, as a writer, I’m hugely grateful for the focus and clarity it has afforded my life. #Thanks.

Thought You Should See This, August 10th, 2012



The eagle-eyed among you will have noticed there hasn’t been a Thought You Should See This update for a while. That’s because I’m working on a book at the moment and wrangling with how to manage a fierce deadline alongside writing the blog. Safe to say, this is an imperfect science, so updates will likely be a little more haphazard over the next month or so. For now, a bumper crop of stories here for your delectation:

Amazon will pay up to 95% of the tuition, textbook and associated fees for its employees’ continuing education, in the e-tail giant’s new push to invest in vocational training.

This is wonderful: an interactive book review written in Javascript. Beautifully done by Robin Sloan. (Screenshot above.)

Chip Kidd’s proposed ad designs for New York’s subway cards. Charming.

My friend, the designer Brian Collins goes postal on a New York restaurant for its terrible service. Social media mayhem ensues.

Hello Health founder Dr Jay Parkinson has a new venture in the works. Watch a CBS News interview with him talking about Sherpaa, a startup looking to disrupt the bloated, creaking, existing healthcare system in the United States. (Well, New York for starters.) 

Irreverent swag commemorating the Olympic Games in London. Example slogan: “They’re all on steroids.” (Also, yes I am available for comment on the Opening Ceremony. TL;DR Yay British weirdness!)

Designer Stephen Doyle conducts a paper chair into existence in this adorable video.

The Joy of Missing Out, a beautiful piece of writing from blogging entrepreneur, Anil Dash. 

Less whimsical but arguably more important (sorry, Anil): Bill McKibben’s fiery polemic about climate change: Three Simple Numbers That Add Up To Global Catastrophe.

More doom and gloom, as scientist David Eagleman describes Four Ways the Internet Might Let Us Down, including space weather and cyberwarfare.

The New Yorker’s Beijing-based staff writer Evan Osnos interviews designer Jonathan Mak Long on the basis of an image Long made in tribute to Steve Jobs. Some fascinating and unexpected insights into how design actually works in China

Zynga employees are unhappy. A terribly sad account of life and culture at the once hot games shop, stock price of which has plummeted since the company’s IPO. 

Track flu via Twitter? Not sure I buy it, but a natty little video makes the case of what *will* at some point be a space that enjoys sophisticated developments.

Thought You Should See This, July 20th, 2012

This week on the innovation/design blog I write, Thought You Should See This:

Technology investor and entrepreneur, Peter Thiel threw down with Google’s chairman, Eric Schmidt as part of the Fortune Brainstorm Tech event. It was a wide-ranging conversation that spanned many topics, from the true impact of technology innovation to the influence of government on innovation and growth. The pair took on some of the thorny topics of our time, with gusto.

Find out why veterans despise the Red Cross–and understand the implications of making unexpected or unwanted changes to service.

Another service story, this time breaking down “Netflix’s Lost Year” and some of the horrible management decisions senior leadership made in the name of attempting self-disruption.

A smart NYT op ed, The Machine and the Garden, makes the case that the economy is an organic, naturally impaired system, not a perfectly working machine. Interesting and compelling argument.

Two great new projects from Google make me want to pack my bags and head to London. Interactive artist Aaron Koblin has teamed up with Chris Milk again to develop The Exquisite Forest, a riff on old “exquisite corpse” games as part of a collaboration with Tate Modern. Designers also teamed up with the Science Museum to create the Web Lab, a year-long exhibition that meshes the physical and the virtual.

If you want to check out a charming story of one innovator’s grit and persistence, you’d do worse than to read the story of the evolution of Sugru. You’ll likely want to buy some of the miracle material once you’ve seen it, too.

Audi goes Apple: Audi’s just-opened high tech showroom near Piccadilly Circus in London plays to the digitally savvy crowd.

And finally, an interesting research project from General Electric aims to develop an at-home natural gas refueling station (image shown top.) Great stuff.