What I learnt encountering our artwork from a patient’s perspective.
It’s early April 2021 — a period of hope as we emerge from Britain’s longest lock-down yet. And just as I’m starting to fantasise about the pub garden, the group socialising, the sense of reconnection — WHAM.
My bike collides with the emerging car. The aluminium frame buckles like a toy. A window smashes. Momentum carries me clean over the vehicle. I crash onto the road.
What just happened? I lie on the tarmac, confused. Is my knee ok — I think it’s ok to walk... wait, is it ok to walk? Why am I walking strangely? Oh, look, my bike is destroyed.
I’m in shock, and my body is giving me nothing. No pain feedback. No orientation. Instead, questions and adrenalin pump through me. I can’t really fathom what just happened, nor am I really “there”. The world seems to take charge and independently move the situation forward — through all the talk of insurance, the getting off the street, the laying there, the ordering the cab home, the going to bed.
One sleepless night later, I’m in a cab to the Emergency dept. The adrenalin has worn off. The pain is here, and with it, a barrage of questions. What’s up with my knee? What am I going to do if I’m properly injured? Who do I need to inform?
We arrive. I hobble into the queue, the Covid era-kind where everyone stands 2m apart, not speaking. Everything is weird. The child in front has a broken strap on her dungarees. Suddenly, I wonder — I haven’t snapped anything, have I? How would I know if I’d snapped a tendon? Would I have heard it?
I turn the corner, and — just as my brain begins to manufacture yet more unanswerable questions — a voice cuts through the silence:
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Welcome to Homerton Emergency Department
Ok, it’s not actually a voice. It’s a piece of text, on a feature wall, with bold colours set against striking patterns. But in that moment, it’s as if someone has reached out and spoken:
I get it. Nothing up till this moment has made sense. You’ve been lost, amidst a chaotic mix of questions, surprises, and moment-to-moment anxieties. But from here on, I promise that your journey will be logical, coherent, and yet, also humane, characterful. You’re in safe hands.
It transpires that what I’ve been yearning for all this time is a bit of orientation, and a sense of order. My mind has been desperately seeking a direction of travel, and only once I begin to enter the department and see my journey laid out in multiple colours and shapes, does the stream of internal questions begin to subside.
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The strange thing is... I’ve seen this all before. This is the artwork, wayfinding, and information designed by Art in Site (for whom I work), at Homerton University Hospital. Just two years ago, I was taking this same journey, imagining what it would be like to be a patient, as I directed a photoshoot through the space, generating all of the photographs you see in this thread.
Yet, what a difference it makes to encounter this work as a patient. As I cross the threshold, check- in and sit down in a wheelchair, I can already feel a change take place. I’d always loved the work for it’s vibrancy and graphic sensibilities, but it’s only now, as I am wheeled through the space, unable to walk, that I realise how much this work sets a mood for those that need it.
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Every area has its own zone, with its own unique colour palette. Each “pattern”, on closer inspection, has a painterly treatment of hues, along with subtle variations in line or placement that break with the expected order. As I sit down at the waiting area, enjoying the sight-lines into various zones, I am reminded of my former year 5 teacher Mr Minz: a man who charmed everyone with his unusual blend of well-planned, meticulous teaching, yet also, a willingness to introduce playful surprises least when they were expected. The same thing is happening here, in Homerton: a celebratory combination of logical forms and bold, playful drama — we’re all in Emergency after all! Why can’t we have full walls of colour, with improvisations of form, each with its own subtle hues and playful surprises? Why should Emergency departments feel banal, samey, miserable, when they could feel dynamic, empathetic, and coherent?
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The phrase “dramatic design for dramatic places” comes to mind as I wait... with much of my anxiety having abated, my thoughts begin to get pleasantly lost thinking about the fact that operating “theatres” and dramatic stage “theatres” share the same name.... Hospitals are sites of drama — surely their proverbial “stage set” should reflect this?
Feeling more cheerful, I attempt some wise-cracks with the nurse, who wheels me into the X-Ray area. It turns out that maybe this was premature. Clearly I’m still in shock, and my powers of wit/social ability are somewhat limited. I attempt some kind of dad-joke quip about “feeling like a powerful emperor” as I get wheeled along. I’m met with an encouraging, patient smile, the kind you give to a young kitten who’s learning how to use a cat flap.
The rest of my story is not so remarkable, but in a nutshell: I discover I have a fractured knee. The team gives me crutches and a brace. I slowly get back to life, work, and take time to work out how to adjust. My leg must be kept dead straight at all times. Putting on a sock in the morning is a challenge. For some reason I need 9 hours + sleep a night. But otherwise I am totally fine. It will be 5–8 weeks time to heal fully. Fingers crossed it looks like they won’t need to operate.
As I write this, I’m reflecting on how our work — Art in Site’s work — made an impression on me that day, and what it says for Emergency design more broadly:
When you arrive at Emergency Dept, something unexpected has likely happened. You slipped and cut yourself whilst de-stoning that avocado. You fell off your bike. You were involved in a crash. You fell down the stairs.
Whatever it is, every day life will have been disrupted, and if you’re anything like me, this means that you will be in a disorientated state, and your mind will be your own worst enemy. Emergency departments have a million things to think about and get right, and it’s a tricky balance. But, as a Pearson Lloyd/Design Council review showed in 2007, these places are hotbeds of anxiety, and even violence and aggression directed at staff, and one of the key ways to tackle these negative emotional states/ attitudes is through strategically conceived art and design, which helps patients feel better attuned with their journey.
One of our Emergency Department projects — the Adults’ unit at St Thomas’ Hospital, which incorporates video, information, graphic design, illustration, and zen-like animations — showed that this can work in practice, with independent evaluation and staff feedback both pointing to reduced anxiety and aggression:
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“The bold design across the public and private areas has made a phenomenal difference to people‘s experience of A&E. The clarity of colours, consistency of design, and excellent information slices help staff and patients understand the different areas within the department. The Moving Image piece brings a very calming feel to waiting areas and to the relatives’ room (where people sit having been told the worst news possible). I am sure the artwork is one of the reasons we are seeing reduced violence and aggression.”
Dr Simon Eccles, Chief Clinical Information Officer for Health and Care, DHSC, NHSE, NHSI
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When art, information and wayfinding join forces, this hybrid force can do something amazing: it can speak in a very direct way to people, helping them to feel oriented, and to trust in the place and people around them. What’s more, Emergency departments are NEVER subtle places. They are absolutely places of high drama — both literal, social, and psychological. It’s no wonder they are often the subject of entire TV programmes, plot twists, News stories. Most of us don’t want a banal environment, an environment that almost forgets our humanity. We want a place that acknowledges “humans”, not just “patients”, “journeys”, not just “processes”, and “feelings” not just “symptoms”. We want our space, and our story, to feel valued. The arts can achieve that.
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Have you been to an Emergency Department and loved / hated the design / art (or lack thereof)?
We’d love to hear more!
We’ll be positing more on this subject as there is so much more to say on the role of the arts to help Emergency feel humane. And if you’d like to learn more about our Emergency work — check out our projects here.
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