"When cure is not possible, we empower ourselves to facilitate healing," an oncology nurse once told me, "...otherwise we get burnt out." I think of an illness of society, of the zeitgeist, for which we work tirelessly to find a cure; the moonshot. And we get burnt out. And we stand up again to keep walking.
So how does this "patient interview" work? Sibley's Innovation Hub is located on the ground floor. We take the elevator up to 4th floor (for orthopedics) / 5th floor (for oncology) / 6th floor (med-surg). We sanitize our hands, breathe in, enter the unit, and head to the nurse station. We smile, introduce ourselves (that we are from the innovation hub, doing a study on patient experience with sound) and we ask if there are any patients with whom we may be able to do a quick interview. We receive suggestions. Then we go to those rooms and we knock. The first ten seconds, while we introduce ourselves and ask for permission to interview, is the most intimidating. Being a combination of extrovert / introvert, there are days that it feels extra uphill - in a way not much different from going on stage and letting it flow. At the end it is (almost always) the most rewarding, transforming experience, despite everything.
Soon I find out that starting the question with sound/noise makes most patients feel a bit stumbled. In a visually-oriented culture, hearing is sort of a minority of all the senses - it is so subliminal that most of us don't even think about what we are hearing on day to day basis (that's probably why some traditions use the focus on sound as a tool for meditation/mindfulness). So we start the questions with something simple - "Ms. ___, how did you sleep last night?" "Was there anything that you noticed?" "Can you walk us through all the sounds/noises you hear? Of all the sounds, which one is most irritating to you?"
Following the guideline of appreciative inquiry we always end the interview with positive questions - do you like music? What kind of music do you like? What is your favorite place to relax (outside the hospital)?
We did it... in a little over two weeks, with six amazing staff members, we interviewed 40 patients at Sibley, asking for their experience with sound/noise. It has been an emotionally-charged time, in and outside the project, and my thoughts turned inward. In the uncertainty of the first few days, my people-interview-muscle still stiff and awkward, I honestly did not know if we were going anywhere with this at all. When I felt vulnerable I used my memory of my IDEO experience as an anchor - how I went in not knowing what would come out, with faith in the process that something would come out at the end - and it did, by letting go to let it come, in a way I could not conceive previously. This is what my trauma therapist would call "resourcing" - when we cannot eliminate fear, we increase the sense of safety. It was probably the fourth day, when we managed eight interviews in a day, that I finally started to sense a faint, yet somewhat certain, glimpse of a new insight. From there a series of insights snowballed. As Michelangelo said, it felt a bit like "I saw the angel in the marble and carved I set him free." Not sure what kind of solutions will grow out of those insights, but yes, we have now sowed the seeds. This emotional interview process will be the muscle and foundation for everything we do moving forward. The positive energies of our staff - Julia, Alex, Lisa, Carmen, Kaia, Derek - and the amazing support of Sibley Hub - all carried it through. We witnessed the concept - hypothesis and assumptions - coming alive into reality, gaining clarity day by day. Just like the first day when I witnessed the music I created for the first time being played in loud-ass volume at Club Five (oh, back in the day)... for two weeks we listened to what it is that wants to be born. Congratulations, team Sen Sound.
As much of my focus at the moment is dedicated to alleviating unnecessary noise in hospitals, my therapist this morning invited me to think of "unnecessary noise" in our internal thoughts. The perception of quietness is different from silence; it means that soothing sound is louder than irritating sound.
With this thing called "innovation," I repeatedly come to find that transformative insights are hidden in the most basic, mundane, simple stuff, something that is way too obvious and so boring that it has been overlooked. What reveals them is a moment of quietness that allows thoughtful "listening" with caring intentions - what is it that wants to emerge in this field, that I can help make manifest?
In dealing with sound that is "overlooked," I have unexpectedly come to deal with intangibles in our lives - things we cannot see or touch, things we don't talk about, all sorts of things that actually dominate our way of being. Like shades of emotions that don't fit into words. Stories that we tell ourselves that no longer serve us. A glimpse of a new reality.
Yoko and I gather up our things and make for the elevators – we’re conducting our first ever patient interviews today. As we head out of the Innovation Hub, I notice Yoko pull the door open, rather than push it. I always push the door open; it’s less effort. We go up to the floor but Yoko is worried because we don’t have official hospital badges or anything that tags us as part of the Innovation Hub. We rub on hand sanitizer at the start of the hallway, and again at the nursing station. I’m scouting out the rooms, eager to start interviews. Talking to people, connecting with them – this is my favorite part. After waiting a few moments at the station for someone to notice us, Yoko explains our mission to the nurse and asks for recommendations of patients we can interview. The nurse hesitatingly gives us a couple rooms and turns back to her work. We find the first room, rub on hand sanitizer, but the door is closed. I raise my hand to knock but Yoko gestures me away, to the second recommended door. Rub on hand sanitizer. The door this time is partially ajar. Yoko still seems hesitant. I’m so antsy I’m ready to just interview the whole floor, Mormon missionary-style (no kidding, I served a Mormon mission). After deliberating a bit, Yoko decides to go back downstairs and regroup. We rub on hand sanitizer on our way out of the floor. Downstairs Yoko slaps together some badges for us with the Innovation Hub logo on them.
This time, the process was a little more successful – we would go to the floor and spend a little time waiting at the nursing station, which allowed us to ascertain the sound environment of the floor. Then we would receive a couple recommendations. We would go to the rooms and wait again, making sure that the patient was not indisposed or sleeping or busy with visitors. If Yoko called the all-clear, we would go in and start a conversation with the patient. Yoko’s interview style is very attentive. She listens to everything the patient has to say and makes sure the patient doesn’t have anything to add before moving on. My style is chatty – I like to create a sense of comradery, “I know how you feel,” by giving a lot of feedback and finishing thoughts when the patient hesitates. In general, the patients’ responses were good; they were glad to be asked their opinions and to have visitors. That first day, we got two or three interviews and overall we were pleased, knowing it could only pick up from here.
At home, as I was washing off the film of hand sanitizer that builds up after twenty dispenses, I thought about what it means to be the kind of person who pushes open a door instead of the kind of person who pulls open a door. And what does it mean to be the kind of person who knocks on a closed door instead of the kind of person who assumes the door is closed for a reason?
When you push open a door you are the first one through it. When you pull it open, there is space to let others go before you. I think there is a time and place to assert yourself, to be confident as long as you are also being kind. But there is a lot to be said for the patience that is required by asking, waiting, and listening. Then the protocol we had developed for our patient interviews made much more sense to me. We wore the badges because we wanted to be identifiable as to our purpose. We asked for recommendations because we wanted to show respect and deference to the nursing staff. We waited because we wanted to be calm and sure and serene as we entered a patient’s room. We listened because we didn’t want to miss out on an opportunity to discover what the patient really needed. I understood how this process could give us strength and credibility in our cause of making hospitals a place of healing and of Zen.
As Sen Sound is about to start the sound mapping on hospital floors, here's the sound mapping on national scape provided by National Park Service (courtesy of David Cramer who found it) - fascinating, absolutely fascinating.
"Alive Inside"... We have to humanize what it means to be a human. I've been in close conversation with a Sibley's geriatric care specialist who embodies the spirit of compassion and innovation. She told me this documentary is a "must watch," so I did - wow. It has been so true from my experience that this seemingly innocent inquiry about sound/music in healthcare leads to a much deeper conversation about what it means to be alive, the state of healthcare today, neuroscience, and the consumer culture that cannot deal with the notion that we all cannot escape aging and death - it is inevitable and sad and because of that it is beautiful. The hopeful part is this one guy, set out to change the world with a simple (yet profound) vision and conviction, at first encounters cold resistance from the system - even though it seems SO obvious that this could benefit everyone. Then he gets swept away by the millions of youths who resonate with the vision, and it starts to become a movement of its own. It's nice to know that we are part of this movement and there are allies everywhere - what role can I play, how can I serve the best? The system is not an enemy - it wants to change itself as much as we do - so I must learn its language and learn to listen so that together we can find a crack :) As the president said at HU commencement, in a completely different context - "If you think that the only way forward is to be as uncompromising as possible, you will feel good about yourself, you will enjoy a certain moral security, but you will not get what you want. If you do not get what you want long enough, you will eventually think the whole system is rigged. That will lead to more cynicism, not participation — and less participation and a downward spiral of more injustice, anger and despair. And that has never been a source of progress. That is how we cheat ourselves of progress." Dear optimism, please back me up for another few days so I can thrive until my next therapist appointment :)
Mixing and rendering the 20 min "sleepscape" composition first thing in the Monday morning is not... the best... idea.... Zzzzzz. Hope this piece will one day help someone across the globe in a town whose name I cannot pronounce to fade into sweet dreams, like an imaginary teddy bear. Good morning from Halcyon House - oh the imaginary teddy bear, protect us from a bunch of sharks in a mini shark tank tomorrow (last prep before the final pitch).
In May 2016, our team started preliminary research on our "Sound Mapping" pilot at Sibley Memorial Hospital in Washington DC. It feels like exciting detective work, just being present whenever things happen. Interviewing folks is the most nerve-wracking part and yet the most fulfilling. We start by talking about sound in hospitals. We always end up talking about life and death, what it means to be sick and to be well, the healthcare system today, stories of their closest loved one, and what it means to be alive. By the end of the conversation I feel like I've known this person so dearly, as a human. Maybe that is why I am semi-addicted to this project now.
We work so hard to prove measurable factors so that we can make a space for something unmeasurable, something that really matters most, like the poetry in the gesture itself - of knocking on the door and asking.
Another moment of the week was a "sensing journey" to The Washington Home & Community Hospices on Thursday.
I am still processing everything to be able to articulate the inarticulatable.
Tim, the director, walked me through the center, while sharing stories.
Outside in the garden, strong wind was capturing and releasing the petals from a beautiful cherry blossom, like snow, as if to remind me that beauty is beauty because nothing exists forever.
Tim said now they are training doulas. A doula, traditionally, is someone who assists a woman during childbirth - someone who is present at the beginning of life. At the hospice, a doula is someone who is present at the end of life, to assist someone through the transition in peace.
Some say that sound is the last sense to go when we die. What is the last sound I want to hear as I take the very last breath of my life? What was the first sound I heard as I took the very first breath of my life?
Nice to meet you. I am Yoko - founder of Sen Sound, a social enterprise to reimagine the sound environment in hospitals.
I am an ambient electronic musician, cohort 4 fellow at Halcyon Incubator, and Citizen Artist Fellow at Kennedy Center. People say my sound is soothing - like listening to a dream - and it took my work to many interesting places, like IDEO and TEDx.
5 years ago I got sick and had to spend many hours in hospitals. I was so terrified by what I heard - the cacophony of alarms, beeps, people screaming, doors getting slammed. Lying on the bed, I used to wonder - some people say hearing is the last sense to go when we pass away; what is the last sound I get to hear at the end of my life?
Sound is largely ignored in healthcare - even though the aesthetics of it could have a great impact on our sense of wellbeing - and a sense of dignity.
Eventually I got better, and the question remained. I decided to explore ways to help humanize our hospital experience by transform the sound environment - for it to be safer, more soothing, and dare I say, beautiful.
At Sen Sound, we don't design for you; we design with you. So let's talk about your experience, what you wish you could hear in the hospitals of future.