As a creative person, involved primarily with the creation of comfortable surroundings for human beings, I was commissioned by John Thompson of GE Medical Systems, when MRI was in its infancy in Canada, to apply my talents to the development of a comfortable MRI suite prototype. Over ten years later, this ‘prototype’, as well as the methodology through which it is realized, is still evolving, as is the scope to which the same principles apply. Today, we are consulted on a variety of complex situations, where patient contentment-based issues are most likely to be lost in the shuffle of stringent technical logistics.
My big question is: Where does the emotional comfort of the end-user find rightful expression in the building creation process, which is ultimately devoted to health, and healing? My own direct experience, speaking generally, has found that this question is confronted, and accounted for, in the building process – only vicariously. It is sometimes possible to find an inspired team of staff, or management, who have a strong position on the matter, which encourages exploration, but it is generally not mandated. Yet anyone who has spent any time within a hospital environment instinctively recognizes the role that emotional comfort plays in the healing process, both in its presence and, unfortunately, in its absence.
Not only is it imperative to continually remember to put oneself in the ‘shoes’ of the end recipients of our labours when making decisions related to environment, but also in the ‘shoes’ of the working staff, who spend their waking hours confronting other people’s vulnerabilities, apprehensions and fears daily. Every tiny step toward a more conducive, comfortable and supportive environment for working staff is, in my opinion, ultimately transferred into direct benefit for the patient. There is nothing like a nice room to motivate positive human engagement, all round.
In terms of practical principles, any healing environment needs to engender positive associations. Like it or not the aroma of coffee at the front door brings with it powerful associations of comfort that work on many levels. One useful principle of application could be termed the ‘Sensibility of Home’. In the seventies this was construed to mean “make it look like home”, which for no other reason than all our homes look different, this was to become a predictable collision course for disaster. The useful part of the principle confronts all the simple stuff that is not represented in the master planning – the anticipation of small needs – coat hooks, places to secure belongings and put on shoes comfortably, a conveniently placed mirror to throw on some lipstick, the list ends only where one ceases to look. Combine this with as much sensual calm as can be afforded, and simple patient flows that can be easily visualized and discerned and the world is a better place already.
|CT Sim/PET Suite at Princess Margaret Hospital in Toronto.
Photo Credit: jenny Hyctt
A second useful principle to contemplate, which makes an astonishing improvement, is the association of ‘Nature’ – again in the simplest sense. Surrounded by ‘artificial’ materials, ‘artificial’ light, ‘artificial’ air, it is interesting to observe what associations a simple piece of ‘natural’ wood can engender in a hospital setting thanks to the last ten years of development in post-catalyzed lacquers. Natural materials, natural light, combined with a full spectrum of environmental colours consistently produces a desirable result, with very simple means.
By way of small example, critically examine a recently completed CT Sim/PET Suite in a basement level at Princess Margaret Hospital, in Toronto, which had the usual demanding schedules and budgets. The setting had absolutely no possibility of natural light, combined with low existing ceiling possibilities. I believe the pictures to be self-explanatory, but one aspect may require some introduction. The clinical management team persevered, through difficult odds, to integrate a small-scale ‘Visual Therapy’ installation created by nature photographer Joey Fischer, who you might have encountered at the last RSNA [Radiological Society of North America] show in Chicago. While Fischer’s work is quite well known in the United States, I believe that the installation at PMH is his first installation north of the 49th parallel. The illuminated image entitled ‘Spring’ is on axis with the Simulator Table. I am most interested, not in the image itself, as much as the possibility to quietly communicate to the patient the degree to which the ‘small needs’ have also been considered. Time will tell whether true value is to be derived from installations of this kind.
As with most human endeavours, there is always a ‘Python in Paradise’. The creation of comfortable surroundings is not without peril as facility managers faced with the legitimate expressions of inequalities between departments, have no recourse but to resist isolated instances of excellence, and attempt to lower standards in the interest of ‘greater harmony’. Personally, I think the clock is ticking, and we need to do all in our power to raise the standard of our collective life, and thereby find the resources and means to achieve our highest aspirations. I choose to start with small things, and I look forward to encountering your efforts in those moments when I least expect them.