Atul Gawande’s recent publication of “Being Mortal” made waves in the medical community, hitting number one by last month on the New York Times’ best-selling list. Gawande is a talented storyteller and no stranger to commercial success, but the extraordinary reception of “Being Mortal” lies not in his diagnosis of what makes life worth living for the old, but what make lives worth living for us all. His case study in eldercare has broad reaching implications for how we design patient experiences across the healthcare spectrum.
Gawande makes the case that medicine has failed to value quality of life over the extension of life: “Our most cruel failure in how we treat the sick and the aged is the failure to recognize that they have priorities beyond merely being safe and living longer.” He challenges when we should privilege our “wants” or “nice-to-haves” over basic necessities. His stories suggest that even when we are just getting by we should protect the luxury to pursue our higher-order needs, such as indulging in simple pleasures or safeguarding time for social and spiritual connection. The ability to prioritize “wants” enforces their right to and worthiness of indulgence. Protecting our autonomy and our sense of dignity powerfully drives our behavior, even when, and perhaps especially when, we are sick or disabled.
Products and services that cater directly to patients’ higher-order needs are too scarce. “Clinical,” whose original etymology stems from the Greek klinke for “beside,” is now defined by Oxford as “detached and emotionless.” The solution lies in transforming medical procedures, products and services to address the constraints of physical bodies without neglecting patient humanity. Consider the human longing for and appreciation of beauty. “When everything around me reminds me that I’m sick, I just want to feel beautiful,” a young woman admitted in a recent patient interview. In 1917, Duchamp reclaimed the toilet seat’s intrinsic beauty, finding aesthetic merit in one of our most repulsive commodities. The realm of disease and disability is as deserving of beauty as any other domain
Consider one the most invasive and arguably one of the least beautiful of medical procedures, the process of self-catheterization. Hundreds of thousands of Americans each day insert a tube into their urethra to release urine after the loss of bladder function due to cancer, multiple sclerosis, or spinal chord injury. The existing process of catheterizing is logistically awkward and uncomfortably exposing. The equipment and accessories associated with catheterization are unappealing at best and downright terrifying at worst. Sterile tubes and unlabeled lubricating jellies arrive at a patient’s doorstep in transparent medical bags, which patients hide away in the bottom of backpacks.
Black Pebble Medical LLC, a student collaboration launched as an educational project at the Harvard Business School, hopes to help patients find dignity in the daily experience of self-catheterization. Their inaugural product is a carrying case for catheterizing equipment. The bag’s design organizes catheter equipment to facilitate ease of use and minimize risk of infection, but its most important feature is its graceful, colorful, and feminine design, inspired by the handbag lines of Michael Kors and Kate Spade. Products such as Black Pebble’s insist on the place for aesthetic pleasure within the context of chronic condition.
“Medical professionals concentrate on repair of health, not sustenance of the soul,”Gawande concludes. To patients, to the poor, to all mortals, there are more important things than getting by. Beautiful, sympathetic design has the potential nourish the soul, not just for the dying, but for patients every day.
Stephanie researched and refined this post with the help of Black Pebble Medical, a Harvard Business School start-up team, including Stephanie Marton, Andrea Blankmeyer, Evan Caplan, Jordan Kraft, and Karthik Prasad. Please reach out to firstname.lastname@example.org with questions about Black Pebble or medical products and services for self-catheterizing patients.