Hospitals in the Eyes of a Mother, and a Cancer Patient

This article contains a few Filipino words from the interviewees but their message can be understood nevertheless.

In this article, narratives of two women who had experiences in hospital environments were shared: one is a mother of a 3-year old, and the second was a patient herself. (1) Jessa Roque-Medina was an intern for Philippine General Hospital and mother of Saab, a three-year-old who was diagnosed with Billary Atresia. On the other hand, (2) Irish Jain, a 20-year-old who had been cancer-free for 3 years now. 

It is not surprising information that spaces inside a hospital, in general, feel cold. It is mainly due to the blank walls and eerie silence that fills most spaces. After spending some time inside hospitals due to chemotherapy and frequent checkups, Irish confessed that there was a time that she had been scared to go to a hospital. She feels like someone’s giving a death sentence somewhere whenever she goes inside, and that thought makes her uncomfortable. Even the seats that lined up on both sides of the corridor—where she had to sit for about 2 hours to see her doctor—add to her growing discomfort as those seats become chilly over time and they make your back ache.

Having gone to India for 18 months for a liver transplant for Saab, Mrs. Medina shared that whenever they are en-route to the hospital from the hotel, as soon as Saab sees the facade of the hospital, she starts to cry. She observed that her three-year-old daughter had developed “trauma sa mga taong naka-scrub suits.” Recently, she noticed that Saab’s reacting differently whenever she is enclosed with a few people in a room (i.e Mrs. Medina, Saab, and someone unfamiliar). Currently, in Manila, Saab starts to plead to her mom to go home whenever she sees the building of the National Kidney Transplant Institute (NKTI). Even as a three-year old, Saab had learned to associate pain to hospitals and people wearing white, but it’s still early to know if it had other impacts on her mental health too.

Private and Public

Although hospitals, in general, feel unwelcoming, unfortunately, as Mrs. Medina concluded, “It always goes and boils down to budget. How much are you willing to pay; that is the exact treatment you’ll get—not medical—pero that’s the exact thing you will get in a hospital.” As a former intern at PGH, she witnessed how beds, beddings, and air conditioners are always inadequate to the crowd of people wanting to get treated. But, she is aware that the environment isn’t exactly the main priority for public hospitals. 

Irish once had a check-up at Philippine Children’s Medical Center last 2017, and one of the reasons why she did not have her chemotherapy there was because of the environment. She described that the hospital is currently under renovation during that time, and the building looks so old. The walls were not blank white walls, but they do not have paint at all. The doctors in the hospital do not have their personal clinics; they were inside a huge room, and the only thing that separates them is curtains. The patients of other doctors were visible, and once it’s your turn, you had to check every curtain to look for your doctor. Although she liked her doctor at PCMC, the environment itself did not make her feel that she can get treated well. Hence, she chose Mary Mediatrix Medical Center, a private hospital near her home, to receive chemotherapy.

Both women mentioned that they feel that they are well-taken care of if they are in a private hospital, but they still feel uneasy inside a hospital.

Coping Up

No one wants to go to a hospital, or even spent a lot of time there, but that is neither an excuse nor a reason to not design an environment that eases psychological tension for patients and their family. 

Saab and her parents had come to the point where they spent six months straight in the hospital in India, and Mrs. Medina suggests that having rooms designed with a homey feeling would be helpful. She also mentioned that accent walls are great additions too. In the past,  Mrs. Medina had her check-ups at St. Luke’s Medical Center – Global City and she compared it to a 5-star hotel. Almost everything feels like a hotel, from the chandeliers to the consultation areas of the doctors. But underneath these un-hospital-like environments that make the spaces feel less traumatizing is the cost of treatment. “Siyempre they cannot give a first-class and world-class treatment kapag hindi enough ang pumapasok na income,” she stated.

Having spent time in a hospital when she was 17 years old, Irish highlights the importance of community to her well-being. She did her treatment at a private hospital owned by Catholics (which is good for her because she’s a Catholic as well), and because of the tight-knit religious community, she became close with the nurses. But she suggests having a common room wherein patients can interact and support one another in each other’s healing journeys. Also, the feeling of belongingness has a huge positive impact on a person’s overall well-being. 

Irish described how ecstatic she is whenever she is in UST hospital for her regular checkup, especially if it’s the holiday season. The lobby of the said hospital is adorned with fairy lights and other Christmas decors. She mentioned that the feeling itself inside the hospital changes when it’s nearing Christmas. When it’s not the holiday season, Irish is delighted by all the paintings that hung on every wall. “Dito kasi sa [hospital sa] Lipa, minsan mo lang makikita [‘yung mga painting] tapos sa pediatrics pa siya and luckily, 17 pa lang naman ako nung nagka-cancer, so dun ako sa pediatrics.” she shared.

The Lesser It Feels Like A Hospital, The Better

Watching how her three-year-old daughter developed a trauma after being in hospitals most of the time, Mrs. Medina stated, “The lesser it looks like a hospital, the lesser traumatizing it would be [and] the lesser fearful it would be.” Interestingly, even Irish reached the same conclusion, “[Basically] parang lahat na makakabawas na feeling na you’re in the hospital. Kasi may common na feeling kayo kapag nasa hospital. It is sullen. Parang feel mo lahat ng tao dun may problema. Pero kunwari [kapag] may library, may magandang cafe, parang hindi mo masyadong feel [na nasa hospital ka].” 

Saab is still very young to determine how her experiences in hospitals affected her mental health. On the other hand, Irish had been scared of going to a hospital for some time because it would remind her of her breakdowns— the moment when she learned that she has cancer. Fortunately, Irish began to heal, especially when the environment of the hospital became joyful due to the Christmas decorations. 

The environment has a huge impact on one’s well-being. It can make you feel that you are being sentenced to death, or it can uplift your spirit and can ease a bit of tension that you are feeling. It makes a huge difference being in an environment that makes you feel that you are welcomed, and it doesn’t add to the agony that you are feeling but still allows you to feel joy alongside the distress.

Using Game Principles to Design Spaces and Products

Yuri Zaitsev mentioned in his talk entitled “Game Principle To Design Products For Fun” that there are several types of fun in a game. One of them is fellowship- the sense of community in a game. In other words, players working together towards the same goal.

I have been playing Working at a Pizza Place for an hour or less for a few days now. In this game, there are roles such as the manager, cashier, cook, pizza boxer, delivery, and supplier. Each role has a specific job. Any player can choose and change their role whenever they wanted.

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You will be playing this game in real-time with other 11 players or less. Sometimes, some players will not do their jobs and just be idle but, thank Heavens, some players do their jobs. Altogether, everyone works well.

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The main reason why I am so hooked at this game is that I feel that I have a purpose. In the game, everyone’s job is crucial similar to a real-life pizza place. The game makes you feel that what you are doing has a purpose because you are not working only for your gain. Other players in the server rely on you as well so that they could properly do their jobs too.

Fellowship is the type of fun that the designer of Working at a Pizza Place has incorporated in the game. I am someone who volunteers especially if it is something related to community building. Probably why I find WAAPP absolutely fun.

Moreover, once I had learned the different types of fun in a game, I began to look for examples in the real-world that incorporate the various types of fun.

But before that, here are the other types of fun that I learned from Yuri Zaitsev:

● Narrative – has a story to tell
● Sensation – uses various senses
● Fantasy – turns on your imagination
● Challenge – learning a new skill
● Discovery – discovering something new
● Expression
● Abnegation – a sense of peace or real one

An example is the Adventure Series™.

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Pirate Adventure Theme. Source: GE Healthcare

Seeing first-hand how a child reacted to seeing his work, the MRI Scanner, like one big scary machine, prompted designer Doug Dietz to design the MRI suit in a human-centered way.

The Adventure Series™ incorporated the fantasy and narrative types of fun in its design. Kids enter the room and spend their session inside like they are the main character of a fantasy book. Operators follow a script that they need to narrate to pediatric patients throughout the session. Fantastical elements are painted from the walls, floor, ceiling, and even the MRI Scanner itself. Doug Dietz and his team were able to make the MRI session for young patients fun and memorable instead of something dreadful and traumatizing to some.

80% of pediatric patients sedated before to only 2 patients after the first year of Adventure Series™.