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.


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, April 20th, 2012

This week’s posts on my innovation/design themed blog, Thought You Should See This:

Of course, top billing this week goes to Monitor/Doblin’s own Bansi Nagji and Geoff Tuff, proud authors of the lead feature story in May’s Harvard Business Review. Managing Your Innovation Portfolio describes the practice of “total innovation.”

I loved this story of crowdsourcing for the ages. Car blog Jalopnik posted a call for its readers to help the Waynesboro, VA Police Department in identifying a part that came off the car of a driver involved in a fatal hit-and-run accident. The commenters came good–and two suspects are now being held in custody. Small comfort for the victim’s family, of course, but a heartwarming tale of the power of crowdsourcing.

Gary T DiCamillo, former chief executive at Polaroid, gave an insight into why the former innovation giant stumbled in a New York Times piece, Innovation Isn’t Easy, Especially Midstream.

MFA student Rachel Lehrer spent seven months tracking handwashing compliance in hospitals. This piece is a fascinating insight into the many contradictory pressures faced by those looking to implement design principles in both their broadest sense–and in contexts unused to the influence or potential of design.

“Soccer is a metaphor for creative collaboration in a team, and coaching soccer can likewise be a metaphor for effective leadership.” Goal Play!: Leadership Lessons From The Soccer Field, by Paul Levy, sounds like a good read.

Head of Google X, Sebastian Thrun, describes Udacity, his extracurricular efforts to create the higher education institution of the future.

Lots of approving buzz for the launch of the Innovator’s Patent Agreement by Twitter. Patents are a hotly contested tool of innovation, with patent trolls and high-dollar lawsuits stifling and impeding the flow of ideas necessary for a thriving economy and its flourishing businesses. This aims to act as a counter force.

The Times has a good breakdown of Sony’s strategy, and some great insights into how once unassailable-seeming giants can fall from grace–including that all-important factor, company culture.

And finally, for anyone excitedly awaiting Ridley Scott’s upcoming movie, Prometheus, here’s a terrifying trailer made by my dear friend, Johnny Hardstaff (top). Very cool, and very totally and utterly terrifying.

Why Design Now: World Health Challenges

A few weeks ago, I dragged my cold-addled self to the Lincoln Center to moderate a panel on the role of design in health care as part of the Why Design Now symposium organized by the Cooper-Hewitt and GE. I was completely foggy and somewhat braindead (you know when you feel like you’re underwater, and everything is totally surreal?) but the panelists were fantastic. Smart, engaged, thoughtful and really trying to use design to make a difference in healthcare in very different contexts. Jose Gomez-Marquez is program director of the Innovations in International Health innovation platform out of MIT, working most often in developing countries; Lorna Ross is design manager and creative lead of Mayo Clinic’s Center for Innovation while Bob Schwartz is general manager of global design at corporate giant, GE Healthcare. The video is below, while the other videos from the day are here. My thanks to all of the panelists for making my job super easy, and to Marc Schiller and his team at Electric Artists for inviting me to play a part in proceedings.