What Happened to Patient-Centered Design?

Metropolis’s editor-in-chief questions how we can connect healthcare design and nature

Courtesy photogramma1 on Flickr under Creative Commons

The Florida firmament was luminous, a flawless blue on that day in May. But the sky’s reassuring beauty could not be seen from inside the gray hospital room with its whirring and clicking machines. The bed was turned from the window, and all the patient could see at the foot of her bed was a mysterious chart and a transparent cabinet filled with sponges, gauze, and other low-tech aids.

My sister was in that bed. She was dying an agonizing death from stage-four pancreatic cancer, literally wasting away. In a morphine stupor for most of her last days on earth, she emerged for a few moments with all her former clarity of mind and thought intact. Greeting all of us with her usual endearing words, she looked at me and said, “I’m going.” She smiled, pointed upwards, and added, “To the sky.” Then she followed up with her words of encouragement and love for each one of us gathered around her.

Afterwards, when her words were no longer intelligible, I contemplated that single window in her room. I thought of what it would have meant to her—and to countless others—if in her last conscious moments she could have seen the sky, maybe even watch it change, like she had during happier days. I thought of the sky as the one overwhelming connection we have to the natural world.

I also thought of how, for years, I was in the habit of asking interior designers about the place where they longed to be. Interestingly, they never wanted to be in a room. They all talked about some natural setting somewhere: the seashore, the lake, the woods, the mountains, the garden—under the great dome of the sky.

The only contact my sister had with nature was a gooseneck, flat-screen TV, with a waterfall video looping endlessly to spa music. The room, the video, the music added to my sadness. Through it all I kept asking myself: Have we separated ourselves so far from nature that we no longer recognize its healing power unless it’s served up via technology?

And what happened to “patient-centered design,” the mantra of today’s health-care specialists? How can design be centered on human needs, both physical and psychological, when it doesn’t recognize our basic connection to the earth and sky? I’m now waiting, not so patiently, for a time when we begin to understand the deep connection between the built environment and the natural environment—and us. Perhaps then life and death will be about connecting to something bigger than us, something reassuring and ever-present that also feeds our soaring dreams and thrills our imaginations.

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