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.

Connecting: a documentary on interaction design

I answered a few questions for this documentary on interaction design, which features all sorts of bigwigs saying lots of things I’m not sure I entirely understand. I also apologize for using the word “synergy,” which is a terrible word (but makes sense in the context? Ok fine. I won’t do it again.)

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

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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.

Thought You Should See This, July 13th, 2012

This week’s updates on the innovation/design-themed blog I write, Thought You Should See This:

Check out my colleague, Erik Kiaer, who presented at the Design Management Institute-organized conference “Balancing Extremes.” You can see video of Erik in action, or catch the presentation in slide format. Meanwhile, Brian Quinn was quoted in a Chicago Business article looking at design community business, Threadless, which caused me to wax nostalgic about my T-shirt days of yore.

Interesting look inside Fisher Price’s Apple store-like research and design lab in East Aurora, N.Y.

The Christian Science Monitor looks at how the ideals of the collaborative economy are being embraced by those in Spain looking to find a way away from their economic woes.

Uplifting life advice from USC professor, Elyn Saks, who suffers from schizophrenia and who wrote an incredibly moving book about her treatment and experiences.

“Civility isn’t fancy-talk for “being nice.” It’s the essential quality we require to live together in complex social structures built on our jumpy, irrational primate brains. Online, where we increasingly live, we need it more than ever.” Must-read piece about trolling and hatespeak by Erin Kissane.

A stark editorial from the New York Times on the impact of climate change. Now will we pay attention and read the writing on the wall? Please?

Great piece with some wonderful anecdotes about Amazon CEO Jeff Bezos’ approach to customer service.

Check out some video of me in conversation with award-winning reporter Liza Mundy, who’s most recently the author of the book, The Richer Sex: How the new majority of female breadwinners is transforming sex, love, and family.

And finally, a slightly tired rant sparked by this throwaway comment in a piece about bank scandals: “Company executives are paid to maximize profits, not to behave ethically.” But really, doesn’t that just about sum it all up?

Thought You Should See This, July 6th, 2012

I know, it’s been a while since a bona fide TYSST update, but I haven’t been neglectful, I promise. Instead, I went to Edinburgh to report from TEDGlobal, where I caught a cold and the strongest conference in years. As you can see from the length of this update, there was much to note (and many speakers I didn’t recap here, so do check the TED blog for the others.)

So here, in no particular order, the highlights of TEDGlobal:

USC law professor Elyn Saks powerfully recounted her own story of mental illness—and the shocking state of the way we treat it. Did you know that LA County Jail is essentially the biggest psychiatric facility in the United States? Neither did I.

Massimo Banzi is the co-founder of the Arduino project, an interaction designer and an educator, and he gave a spirited talk that was chock full of great examples of the boundless creativity and innovation that comes with an open platform.

Macrowikinomics author Don Tapscott outlined the open world according to four principles: collaboration; transparency; sharing and empowerment.

Shyam Sankar, a data intelligence agent working at Palantir, gave a great talk citing J.C.R. Licklider’s notion of intelligence augmentation and the need for humans and machines to cooperate, not fight one another. I also talked with Palantir’s lead graphic designer Collin Roe-Raymond about the beautiful presentation they put together. See the top image–slides matter!

Hong Kong-based Bloomberg correspondent Robyn Meredith spoke about the Chinese dream—and what it means for the west.

Admiral James Stavridis is the Supreme Commander of NATO and a proponent of what he calls “open-source security.” Great talk.

Matt Mills and Tamara Roukaerts of Aurasma showed what’s possible in blending physical and digital.

Sculptor and artist Antony Gormley is amazing and my crush is out of control. That is all.

Kathy Hinde is an audio-visual artist whose work is pretty extraordinary. Watch the video.

Stanford professor Daphne Koller described her new online learning system, Coursera, which has seen 640,000 students from 190 countries view 14 million videos and take 6 million quizzes. Much to pay attention to here.

Pankaj Ghemawat is the author of Global 3.0: Global Prosperity and How to Achieve It and the provocative article, The World Is Not Flat. He asked one important question: how global are we, really?

Writer Robert Neuwirth outlined his thesis of “System D,” the informal economy that employs 1.8 billion people and is worth $10 trillion/year.

German politician Malte Spitz explained what happened when he got Deutsche Telekom to hand over the data they’d retained on him over a six month period—-and outlined the true, scary ramifications.

Anthropologist and academic Gabriella Coleman set out to explain the mysterious group Anonymous.

Leslie Chang has written about the reality of life in factories in China by taking a radical approach: talking to those who work in them.

Neil Harbisson is totally color blind; that means he sees a totally grey world. He explained how he’s turned this apparent defect into an artistic opportunity, learning how to “hear color” as a self-proclaimed “cyborgist and colorist.”

Ruby Wax gave a sparky presentation examining the stigma of depression and mental illness throughout our allegedly sophisticated society.

Robert Legato has won two Oscars for his visual effects magic, and he charmingly drew back the curtain on some of his most famous effects for films including Apollo 13, Titanic and Hugo.

Vicki Arroyo, the executive director of the Georgetown Climate Center, gave a fiery speech in which she took on the topic of inevitable climate change disruption–and what we need to do about it.

Collaborative Consumption evangelist Rachel Botsman gave a talk chock full of excellent examples of companies that are experimenting—and winning with this new economy.

Harvard Business School professor Amy Cuddy recounted the story of suffering a car accident that landed her in rehab with a significantly decreased IQ. So she made everyone cry, and then sent us off with a spring in our step.

Lawyer and campaigner Jason McCue freaked everyone out by setting off a fake bomb and then making the case that we do not do enough for victims. “Yet victims are the best weapon we have against more terrorism.”

Marc Goodman tried to make out that the sophistication of current criminals shouldn’t terrify us, it should inspire us. He was somewhat successful, but I’ll be honest, his examples certainly scared the bejeesus out of all of us.

Deyan Sudjic, director of the Design Museum in London, turned up to a session on transparency at TEDGlobal to give a speech in praise of opacity. Typical designer ;)

While traditional leaders want to be right, creative leaders *hope* to be right.” John Maeda’s talk was a treat.

John Wilbanks spoke to confess he’s perfectly happy to share all of his medical data. In fact, he’s building a system out of it. This will be a potentially huge movement, to which we should all absolutely pay attention.

Michael Anti is a reporter and a blogger who gave us a snapshot of real Internet life in China. Fascinating, even for western digital poster children.

Kirby Ferguson pointed out a disconnect that has bothered me for an eon: Steve Jobs’ cavalier attitude towards multitouch technology, which was provably untrue, along with his emotional outburst about Google and Android.

Andrew Blum has devoted the past few years of his life to figuring out how the Internet really works, a journey that took him to huge, dark data centers and to beaches in Portugal to watch a pirate climb out of the sea.

The always-excellent Clay Shirky closed out this year’s conference, making the case that “more media always means more argument… That’s what happens when media space expands.”

One added bonus: watch San Diego’s Fourth of July fireworks, a display that should have taken 18 minutes that was over in 15 seconds. Not that this Brit gloats over any Independence Day misfires, of course.

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