don’t design the solution until you understand the problem

About two months ago, my friend Thomas asked me over dinner why I don’t publicize my blog or push content to Facebook. I had to laugh a little. I don’t really push content to Facebook (although I’m getting better!), and I don’t consider myself a “real blogger”. 

Truthfully, sometimes I feel like I don’t put enough time into my writing. I justify it to myself by saying that I’m busy, or I’m tired, or I don’t have enough good content to weave into a post. And by not publicizing it, I let myself off the hook for not pushing myself.

If I hired you as a consultant to help me design my life to accommodate blogging better, what would you tell me? Block out time on my calendar to write each week? Each day? Keep a running list of topics that strike my interest? Find a quiet place without distractions that stimulates writing?

Three weeks ago, waiting on a plane from ATL —> DEN, I had three hours to kill. Perfect time to blog about what it takes to understand needs in product design, I thought. I had just started a new job, and was spending lots of time in the Holy Trinity of device design - the lab, the clinic, and the whiteboard. I sat down with a glass of wine, and wrote… absolutely nothing.


What I was doing in Denver :).

Can you understand what my problem is? If you know me in real life, you might (I’d be impressed if you did). If you work with me on a day-to-day, it might be a little clearer. It took me two weeks to figure it out, and I live with myself.

There’s little that’s more frustrating than finding the right solution to the wrong problem. My problem is not time. It’s not motivation. It’s not a lack of content. I keep a 15-page Word document on my desktop with topics, links, and ideas that I want to explore in writing. I set aside time every week to write, and I write plenty in a day. 

In technology, there’s a dangerous tendency to design products that we are capable of producing. The larger a company gets and the greater its capital investment in a particular technology, the less likely they can be to branch out and create something new. But customers aren’t surprised and delighted by economies of scale. Rather, they are enchanted by solutions to their real problems.

Check out this USA Today article about solar panels in India. Houses in the rural countryside have been wired for the grid for years without having access to electricity. The electric company in the area is trying to answer the question, “How can we increase capacity to expand the grid faster?” But people in the rural countryside are bypassing that question, and asking, “How do we get electricity without relying on the grid at all?”

Or how about this Fortune article about P&G shampoo in China? A Fortune editor tags along on a trip to Shahe to watch a woman wash her hair, and makes the assumption that Wei Xiao Yan’s first priority is function - to have clean hair. After all, she lives in a part of the developing world where people spend less than $5 a day to survive. But when she’s given the proposition of cutting it, we learn that her primary motivation is beauty - to look pretty for her husband.

These may seem like subtle nuances, but these subtle nuances about user needs are the difference between products that users love to use, and products that users don’t use.

Did you know that Facebook has an analog design lab? The idea is not to create the greatest technical solution that you can - the idea is to “build a system that actively maps people’s relationships in the world - offline”. The only way to design something that interacts with people the way they need to be interacted with, is to understand that interaction. That’s meaningful social.


How this post started out.

Here’s the correct answer to the consultant question: I start all my posts on paper. Like, with a real pencil. I am a whiteboarder. A Sharpie addict. They’re not written out in their entirety (even I’m not THAT old-school), but I like to map my ideas out on paper - literally. Every blog post now starts on a piece of cardstock - even the paper is important, because cardstock gives a very real sense of gravity and substance. And what I didn’t have with me in the airport that day was a piece of paper and a pen.

It dawned on me as I was walking into Hartsfield last week with an hour before the boarding door closed. I had a five hour flight in front of me, and no pen in my bag. So I hustled down to One Flew South in Concourse E to bum a pen off of Tiffany before I got on my plane and started writing.

is it a yes, or is it a no?

Dear Diary,

Guess what I did at work today? I lubed up Foley catheters with baby oil and inserted them into an acrylic model of the prostatic curve.

Over, and over, and over.


Yum.

I’ve gone through the design input process for half a dozen disparate medical devices - everything from vascular stabilization, to imaging, to interventional cardiology. Each device has addressed a very different unmet clinical need; each device, not surprisingly, has had a very different set of design inputs associated with it.

Except one (one input to rule them all, I guess). Every time I sit down in a design inputs meeting, without fail, someone says, “It’s got to be easy to use.”

This sentence is what keeps me up at night. At the end of the day, technology is easy to quantify. Science is easy to quantify. When a device I developed makes it to a patient, I know that the science behind it is sound, and the testing is robust.

We try our hardest to quantify procedure time, insertion force, stiction - but ease of use is not a particularly good engineering input. The only way to know if your device is easy to use is to use it. A lot. With a lot of different people. It means building it twenty times before you ever draw the final plans. It means testing, and it means failing your design objectives a hundred times before you figure out how to get it right.

And once you’ve done that, it means taking a leap of faith to decide that yes, this product is easy to use.

I’m seriously considering enrolling at Stanford’s GSB just to take this class. Cartwheels aside, the article has a great reflection from Heidi Roizen: 

When you’re analyzing a situation, you eventually get to a point at which you ask yourself, ‘Is it a yes, or is it a no?’ And you just know the answer. 

Ease of use is one of those things that one day, just clicks. So here’s how to get to that point (without losing as much sleep as I do, maybe):

1. Do your homework. Know what your design objectives are. Know who’s going to be using this. Know what they find easy. 

2. Build. And build. And build some more. Your first prototypes will suck. The first device I ever designed was a cardiac ablation mesh that could map electric potentials across the pericardium, and then reverse the energy to ablate those areas we mapped as fibrillation points. We spent two months building ONE high-fidelity prototype. In retrospect, we could have doubled our understanding by building two prototypes that weren’t as intricate.


Somewhere, I have photos of the CardioMap build. But I prefer this picture of eating pig hearts after we used them for testing. Eat your heart out… ?

3. Fail. A lot. You don’t know what’s easy to use until you also know what’s not easy to use. So build things that aren’t easy to use and use them as comparison points.

My goal in my new job is to fail, quickly, cheaply, a lot, so that when we get out of Concept Phase and we hand our projects off to the commercialization team, we’ve gotten the product failures out of the way. So I get the pleasure of spending my Friday simulating insertion of a urinary catheter through torturous male anatomy (for you gentlemen who don’t have a background in healthcare, don’t Google this).

4. Make a decision, and move on. Once you’ve done your homework, and you’ve tried your ideas, you’ll know. Ease of use is one of those things that you “know it when you see it.” So stop overanalyzing. Do your homework, and then trust your gut. And get some sleep.

just another designer’s Steve Jobs story

I’ll keep this short, as there will be far more eloquent tributes to Steve Jobs than I could ever write. The news broke via text message on my iPhone. I immediately opened up my Macbook Air to have a FaceTime conversation about Jobs and Apple’s future, before sitting down to write this post on my iMac.

I did not know the man, and I am not a “fanboy” (although my brother might disagree). I own as many machines that run Windows as I do Snow Leopard. But there is a reason, as a designer, that, when left to my own devices, I chose to buy Apple products.

Like him or hate him, Steve understood the difference between features and usability. Microsoft is feature-laden and experience-poor. Apple focused, and continues to do so, on the entire experience of using a piece of hardware. The designer in us marvels at Steve’s ability to separate technology from use - where most designers and companies (consciously or unconsciously) start with “what do we have the capability to create?”, Steve’s fundamental question was “what do people want to do?”

Fifteen years ago, my parents gave me my first Apple computer. I would stay up just a little longer playing Math Dodger past bedtime (I’m an Indian kid, we only got nerdy computer games).


The remains of a relic Macintosh II that I spent hours on once upon a time.

Coming full circle, I bought my parents an iPad earlier this year. And now, they stay up just a little longer past bedtime to say good night on FaceTime from opposite sides of the world.

And one more thing, Steve…

Thanks.

freedom to operate

We filed our patent application today. My first real (nonprovisional) patent. I’m first inventor. Pretty exciting. Or, at least, I should be.

Product development is a messy process. It’s been over five months since we first saw the retention mechanism design in polycarbonate, and a shade under a year since our first prototypes in Acura 55 SLA. I used to think that making cool stuff that people wanted was about having a good idea. But the idea is only the beginning. 

In the industrial economy, we monetized things. In the service economy, we monetized people. And now, in the knowledge economy, we monetize ideas. 

But how does one own an idea? We give freedom to operate for being the first person to disclose a thought on how to make something or do something. But how can we be sure that this was the first person to have that thought, or think of this design? When I sign our application as the First Inventor, how can I know that this particular retention mechanism for this particular application has never crossed the minds of any one of the billions of people that I have shared this planet with?

It doesn’t much matter. The magic is not in the design, or the material, or the patent. The magic is in being able to meet a patient’s needs. The magic is in giving a patient freedom to operate in their daily lives. 

We don’t design products; we design outcomes.

perspective on design validation

I’m tired. And I’ve been working late. And I’m frustrated with Mexico and ready to get through this product launch and take a vacation. These are the kinds of days that you really need to see things like this:


A Phoenix area newspaper this week.

Normally unremarkable. A woman with a baby. Cord blood donation for minorities (which, by the way, is a huge need right now). But I count at least two Bard products in the picture, one of which I’ve worked with (never mind that it’s being used incorrectly….). Perspective.

There’s little that’s more rewarding than seeing your product in use. Doubly so when that product directly affects health and well-being of its users. Couple that with the fact that 80% of ideas are killed before they see the light of the marketplace (anecdotally, that holds to be true, but everyone seems to have their thoughts on the actual statistic), and I know that I’m lucky to be launching my first major new product so early in my career.

As we go through launch plans and wrap up our final build documentation and testing, one of the things that’s weighing heavily on me is Design Validation. For those that aren’t familiar, design verification is the answer to the question “did we build it right?” It’s why I’ve spent time at the molder and the manufacturing plant, done all sorts of testing. Design validation is the answer to the question “did we build the right thing?” That’s a little bit trickier to answer.

In a procedures-based environment, we are constantly designing to user tasks - what is it that a surgeon or internist wants to do? How can we help them do it faster, better, cheaper? Design validation, then, seems most natural in clinical trials, or simulated use tests. But with sample size requirements, IRB protocols, access to clinical sites, and targeted patient populations, that’s not always practical to get that in-depth. Sometimes, it makes more sense to release the product with an understanding of how it’s going to be used (safely and efficaciously, of course) and let the market decide for you if it’s the “right product”. 

In school I always struggled with the idea that we need to release products quickly. It seemed like such an “industry” thing to say, to release faster and make more money. And while it’s true that faster launches do mean more revenue, they also mean that patients get their hands on things faster. 

When I look at a picture like the one in the newspaper, I remember what validation feels like. It’s seeing a smile on a mom’s face to know her infant is healthy. It’s hearing a grandchild tell you thank you for making sure her Nana’s medication got to her in time. It’s seeing a patient start to exercise again after a mitral valve repair surgery.

Perspective.

the days are long, but the years are short

(I stole that quote from The Happiness Project)

Some mornings I stress about my work schedule. And then that makes me stress about how little sleep I get. And then I worry that I’m not at the gym enough, and that reminds me that I’m definitely not eating right. And by then, I’m too wound up in a ball of worry to enjoy my first few waking moments with the fluffball that wakes me up every day.


The world’s greatest dog in the morning.

In the first five minutes that I’m awake, before I write my 750 words or lace up my running shoes, I spend some time talking to the dog (if you have a dog, you won’t find this strange). Some days it’s the best time I get to spend some real time with her before the hustle sets in. I try not to rush past this time to the thousand things on my to-do list every day. I try and remember that these moments are precious, try to etch in my memory how she yawns, how she puts her paws on my shoulder to stretch. It won’t always be like this, and we won’t always have this time. The days are long, but the years are short. 

In a lot of ways, design is about making the days shorter and the years longer. It’s about finding balance in the day-to-day and beauty in the big picture.

Finding balance is a work in progress. For everyone. It’s not easy to say no to things that are good in favor of things that are great. It’s not easy to design your day-to-day life consciously to live out your big-picture ideal life. 

There’s an awesome blog post from Bronnie Ware, a palliative care nurse, about regrets from the dying that she cared for in the last few weeks of their lives. The most common regret that people have when faced with their mortality is not living the life that made them happy.

No one, on their deathbed, says that I wish I had gone in to work a little bit earlier. Or that they had started work a few months sooner. Take time to do what matters. Spend time with the dog (kids, friends, etc.). Read an interesting book. Take a new class. The days are long, but the years are short.

learning to let go

We’re in the last few hours of the Shuttle era.

Early tomorrow morning, Atlantis will come home for the very last time (with a Tech alum on board). It’s a bittersweet moment, for sure. 


Dane and I with Sandra Magnus at a COE dinner in March. The shuttle program started with a Georgia Tech alum on board, and now we come full circle with Dr. Magnus bringing Atlantis home for the last time.

A lot of questions remain unanswered for the public regarding what’s going to happen to space flight. When private spaceflight will be capable of routine trips to the ISS. How we’re going to continue our research in space. What our role on the International Space Station will be. 

Whatever the reasons may be - budget cuts, politics, an understanding of the limitations of our system’s ability to produce better technology in faster timeframes - the American Government and NASA are choosing to let go.

One of the hardest things you learn as a designer is how to let go of something you’ve poured your heart and soul into. I’ve been told at various times in my career that for every ten idea you spend time developing, only one of them will make it to market. Last week, we made the decision to kill a project that I spent 12 months as the research lead on - a clinical diagnostic that I really, truly believe can make all the difference for critical care patients. We had done technology assessments, prototyped several examples, and even created a model of a circulatory system to demonstrate clinical feasibility. In the end, the market won out, and we knew that the technology we needed can’t scale at a cost that hospitals can manage. It’s a tough pill to swallow, but sometimes, you have to understand the realities of where you are and where you’re trying to go, and realize that maybe you don’t have the best way to get there (yet).


Six years to the day before the last launch of Atlantis, I was behind-the-scenes on a geek trip at Kennedy Space Center.

So kudos, to NASA, and to all the astronauts that have made the program what it is today. It’s been captivating to see what we’re capable of, and it’s bittersweet to let go of a program that taught us to push boundaries. Whatever the next chapter of spaceflight is, we are better off for the things that we’ve learned and the experiences we’ve gained.

less designing products and more designing outcomes

Thanks to Shalini, I started playing with Google+ this weekend. It’s definitely interesting. I set up my Circles, checked out some Streams, tried to put in some Sparks (still haven’t tried Hangouts - if you’re on Plus and want to check it out with me, let me know!). My first thought mirrored the xkcd cartoon, “It’s not facebook… but it’s just like facebook!”

Rocky Agrawal wrote a great post about Circles yesterday. In particular:

The biggest unsolved problem in social networking remains unsolved with Google+: separating signal from noise. Twitter, it seems, doesn’t even want to try. The timeline is as dumb as it has been since the beginning, a reverse chron firehose of information. Facebook’s feed has improved over the years, but a friend in New Jersey trying to get rid of a bookshelf is just not relevant. 
The lack of quality tools for generating signal out of these feeds is inhibiting the creation of content. People are multidimensional and manual segmentation at the person level isn’t enough. I create content about a lot of things, including social networking, mobile, daily deals, my travel, my reading and more. But as I was reading Onward, I shared less than I would have because I didn’t want to flood people’s streams. If I annoy people, they have a blunt tool to fix it: unsubscribe entirely. So I mitigate my posting.

I’m a very selective content consumer, and an even more selective content creator. I blog, but I won’t tweet. I’ll post location on Instagram, but not on Facebook. When it comes to organizing my Reader feed or picking people to follow on Buzz or Tumblr, I’m merciless. And as a creator, my biggest concern is not about privacy (although I make it seem like it is). It’s about irrelevance.

At the end of the day we don’t need more creation and consumption tools. Everyone has their favorites - Facebook, Twitter, LinkedIn, Blogger, Wordpress, Digg, Disqus, Tumblr, Buzz, Flickr, and a thousand others that pop up every day. Right now, all it’s doing is giving us more sites to check to get the content that’s relevant to us. What’s important is how we create value out of these things to generate a stream of content that’s meaningful to us. And I’m hoping that as Google+ grows, it addresses the “signal-to-noise” problem that’s overwhelming our lives.

The future for content sharing is bright, but the path to get there is still nebulous. Kind of like DTW.
The future for content sharing is bright, but the path to get there is still nebulous. Kind of like DTW.

A few months ago I had a great conversation with one of our national sales directors about creating products in healthcare. Healthcare is a great example of a market in which companies have focused on creating and selling products to solve problems. But what’s valuable in healthcare is not products - it’s outcomes. A subtle nuance, but important. Technology on its own is useless, unless it can drive the outcome - better health, less disease, higher quality of life - that we desire. The tool has to reflect the task.

Google has created a tool to drive its market share in social. It’s created a product. But what social needs right now is not products. It’s outcomes.

Consumption and creation are huge topics of interest for me. In fact, it was a conversation over seafood in Midtown about how we create and consume that led to this blog. At that time, it was Google Buzz that was new and exciting in social. Now, as I near my 100th post (we’re up to 98, for those keeping score) more than a year later, I’m excited to see what Google+ does to the creation and consumption landscape.

design lessons i learned from the sunscreen song

Lately I’ve been doing a lot of research about designing clinical interactions. Specifically, in how clinicians can interact with patients to boost healthcare outcomes. It strikes me how similar it all is to happiness research (The Happiness Project was this week’s travel book). Designing smart interactions is like designing a happy life:

1. We’re happier when we have meaningful relationships in our lives. A doctor-patient relationship in which both parties contribute to the conversation leads to better health outcomes and more patient satisfaction.

Also, did you know that the best predictor of loneliness is the number of female friends you have? Male friends don’t make any difference in the loneliness statistics; it’s because women are easier to open up to. This might make a great case for why people prefer female doctors.

I find this sort of worrisome, because I have few female friends.

2. Patients are more likely to be compliant when there is a clear link between action and result. Feedback is a core tenet of interaction design. It’s frustrating to receive instructions from a doctor, follow them meticulously, and not see the intended result. Since health is individual and outcomes are not guarantees, we should design devices to facilitate this kind of feedback as best we can. And related…

3. We shouldn’t compare our outcomes to those of others. You can replicate treatments, but you can’t guarantee outcomes from patient to patient. We’re all different, and it takes different things to make each of us healthy. We’ve all  heard the crazy stories of the man who lived to be 90 smoking a pack a day, and the perfectly healthy marathoner getting metastasizing cancer. Our science is unique; that’s what makes us works of art. Similarly, keeping up with the Joneses doesn’t make you happier, because the things that make you happy are different.

4. Experiences make us happier than things. Visiting someone in the hospital is much more meaningful than sending flowers.

A great line in the book is “there is no love; there are only proofs of love.” This isn’t unlike Khalil Gibran’s line in The Prophet, “Work is love made visible.” Or Covey’s idea that love is a verb, not a feeling. Proactive people treat love as an action. But I digress.

5. People who are grateful for what they have and appreciate their lives the way they are have shorter recovery periods and a higher quality of life. So much so that the American Heart Association has counseling programs for stroke sufferers on positive thinking.

Basically, these are all things I learned from the Sunscreen Song (it’s here if you haven’t heard it). It’s easy to overcomplicate clinical design and positive interactions with bells, and whistles, and features. But there are no secrets to happy, and no secrets to healthy, either.

Get to know your parents; you never know when they’ll be gone for good. Be nice to your siblings - they’re your best link to your past, and the people most likely to stick with you in the future.


Nice enough to let him have the remote.

 Understand that friends come and go, but with a precious few, you should hold on. Work hard to bridge the gaps in geography and lifestyle, because the older you get, the more you need the people you knew when you were young.


I’m thankful to have the kind of friends that bridge gaps in geography and fly into town just to have dinner (thanks, friend!).

Read the directions, even if you don’t follow them.

Don’t waste your time on jealousy. Sometimes you’re ahead; sometimes you’re behind. The race is long, and in the end, it’s only with yourself.

Maybe you’ll marry; maybe you won’t. Maybe you’ll have children; maybe you won’t. Maybe you’ll divorce at 40; maybe you’ll dance the funky chicken at your 75th wedding anniversary. Whatever you do, don’t congratulate yourself too much, and don’t berate yourself. Your choices are half chance. So are everybody else’s.

Dance, even if you have nowhere to do it but in your own living room.

Enjoy your body; use it every way you can. Don’t be afraid of it, or what other people think of it - it is the greatest instrument you will ever own.


Using my body in a new way at Circus Fitness class.

Writing closing sentences has never been a strong suite of mine. It just feels awkward. But I love the ending to the song, which circles back to the research (“but trust me on the sunscreen”). So I’ll circle back to the research:

The findings here are tentative and in need of replication. Until then, including empathy in the clinical encounter has little potential for harm and has positive influences that extend beyond the medical consultation. A “connection” also enhances continuity and builds a foundation for relationship-centered primary care within the patient’s medical home.

commitment, to the problem you want to solve & the life you want to lead

Lunch on Friday in the Financial District. We were sitting in a gorgeous courtyard, full of marble and light and San Francisco sun. I asked Charlie if he ever gets sidelined by the perception from inside a company that consultants come in uninformed about and uninvested in a company’s goals and culture, suggest swooping changes and then leave the actual implementation - the hard part - to someone else.

Sure, he said. But that’s what happens only when the tasks haven’t been well-developed. When a company hires a consultant without knowing what problem they’re trying to solve.

This isn’t so different from product development. I get frustrated with how often requirements change. Of course, time changes things. Patients change. Procedures change. Technology changes. But what can’t change is our commitment to the problem that we were originally trying to solve. That’s the easiest way to kill a good product idea before it hits the market.

You can’t design to a moving target.

Don’t get me wrong. You can design to accommodate change. You can design with a vision of how that design can change. What can replace it. Apple’s the classic example of companies that develop products with multigenerational product strategies. But the point is, commit to something. A set of requirements that may not last forever, but that last for right now and give you something to work towards.

Commitment is a whole separate topic. It takes courage. We’re so afraid of it. We’re afraid of what might happen if we commit to one thing and miss out on ten others. This is true in product development. This is true in life.


Thomas living his ideal life in Napa Valley.

I was reading Unclutterer yesterday when I came across this post. Erin’s post is like Covey’s second habit: begin with the end in mind. I think the hardest part of being young is realizing that it’s ok to change your mind as you get more information. That the ideal life right now doesn’t have to be the ideal life forever, that your life has its own multigenerational design strategy. What shouldn’t change is your commitment to live according to the things that you value. 

five years ago i worked in the emergency room

One of my new goals is to learn everything about core body temperature in the ICU. Why it’s taken, how it’s measured, when it’s used. What information it gives a clinician and how they can use that information to drive clinical interventions. It goes without saying that I’ll be spending some pretty significant time in the hospital over the next several months.

Five years ago this June, I worked in a hospital. Grady Hospital, specifically, in the trauma center. Grady is one of those classic inner-city hospitals you hear about. It’s the largest trauma center in the Southeast, and the only Level I trauma facility within 100 miles of Atlanta. My first day, we intubated a woman shot in the mouth during a work scuffle (she lived). My last day, we watched a chief resident attempt a full thoracotomy on the way to the elevator for a man who had been shot in the chest with an AK-47 (he died).

I was technically a Research Associate. We were supposed to be running four studies for PIs at Emory – interviewing patients, coordinating with pharmacy, observing procedures, the like. Honestly, I don’t remember doing much other than talking to the homeless people about their smoking habits (one of the studies) and waiting for two hours by the bedside of a man who had a seizure while driving so we could measure the extent of his head injury (another study).

What I do remember learning that summer was how little of being a doctor is treating a patient’s condition. Instead, and especially in a place like Grady, it’s about demographics, socioeconomics, and psychology. And paperwork, too.

You do more for a patient by helping them find a job with a decent wage than you do by prescribing anti-depressants. Or by reducing sodium intake instead of prescribing lasix in patients with CHF. Or just by sitting at the bedside with an elderly homeless woman who has thrown herself off a bus to get a place to stay and a person to talk to.

I always meant to be a serious blogger about device design. I think I write about design like James Altucher writes about hedge fund trading (he doesn’t). That summer at Grady was for my medical school dreams what this blog is about my life as a designer.

Five years ago, the day before my birthday, I was at the hospital late. I was scheduled to leave at 8, but at 7:15, we got our first LifeFlight call. A peds case, but no details. In the hospital, “peds” case can be anything from a few months to 18 years old. Half an hour later I rode up to the roof with another research student and a PA, a stretcher and an excited silence between us.


The next day, my 20th birthday.

I don’t remember what actually happened. A helicopter landed. A boy, bigger than I was, was pulled off the board and onto the stretcher. We ran back to hold the elevators for the trauma team on call. I remember pointing out that he might be a candidate subject for a design research study, but quickly dismissing the thought as we took a separate elevator back to the trauma bay.

The details came slowly, from quiet conversations at the nurses’ station and the residents’ orders to the pharmacy. He was 15, spending the holiday weekend at the lake with family. He played football at the local high school. He was a good student.

He had attempted suicide.

His parents came in, having driven from the lake, about 45 minutes later. I vaguely remember the attending dismissing the first and second year residents minutes before they walked in. It’s hard to understand what to say to a parent whose son has just attempted suicide when it’s your first week on the job at Grady’s ER. I remember standing in the corner of Trauma 2, peeking into the next room, thinking that he was just three years younger than I was, and yet we were so far apart.


It’s a patient privacy violation to take pictures of patients in hospitals, but this seemed fitting.

I think about that night a lot. About the look on his parents’ faces when they walked in to that trauma bay. About the promise of a young man’s life – a young man who hadn’t yet learned to drive, or been to the prom, or filled out a college application. About the life that lay ahead of me at 15. About all the things that I had yet to do and see and experience.

Sometimes, when I am in the hospital doing design research, I think about how all the technology in the world can’t save you if you don’t nurture the soul inside you. That all the diagnostics in the world can’t tell you everything that’s going on inside the human body. Design becomes practical to me in that moment. Hope becomes visible. We become human.

multidimensional design and a fresh start

I found out this week I’m switching teams.

For those with a background on the medical side of things, I’m leaving the Vascular Interventions team to head over to Critical Care / Renal Function. From a purely clinical perspective, this is a huge opportunity. Bard’s big business is in Foley catheters (this link may or may not be SFW… depending on where you work), and more than 10% of its annual revenues as a corporation comes from the critical care Foley business. I’m going to be leading a huge project involving core body temperature and diagnostics, and I’m tremendously excited to get started.

Of course, I’m sad to leave my team behind. If you are one of the people that enjoys my gchat status updates during the week, I regret to inform you that the days of ambiguously hilarious updates about “PWOMs” and “LBigs” are numbered (or at least, will be reduced). Over the past two years, we’ve become not only subject-matter experts in venous infusion, but also good friends in the process.

Last week, I sat down with my new boss to discuss human-centered design. It was interesting, in that the conversation was happening between two engineers who see their craft as a balance of logical facts and human misgivings. We are consummate systems thinkers, trying to find where people fit into process.

Not to knock engineers (after all, I am one), but part of our problem in product design is that we try to systemize everything. We want an orderly and repeatable process to come up with orderly and repeatable innovations. Life is messy. It doesn’t flow gracefully in neat, logical form. Instead, it flits its way from idea to idea, lumping together things that have no business being put together.

I’m trying to find my place in between designers and engineers. I think, then, it’s important to build our lives richly, to cultivate experiences that can show us different dimensions of the problems we’re trying to solve. It’s the officially-unofficial first weekend of summer, and as I get ready for a fresh start on Tuesday morning learning about sepsis and kidney function and multiple-organ failure in the ICU, I’m trying to commit myself to an exploration of multi-dimensional design as well.

1. Two-dimensional design. I’m a lousy artist, so I take photographs instead. Here’s a photo that sums up the weekend in Atlanta:


It’s only May…

2. Three-dimensional design. I’ve decided to build a desk. Well, sort of. I wanted to build a desk. Then I realized that there are desks out there that are almost what I want. So I decided to find a desk to repurpose and refinish. But that’s proving to be more difficult than I thought.


Four furniture stores and two hardware stores later, this is the best imitation of butcherblock I could find :-/.

3. Four-dimensional design. A new dance class that reminds me of why I started dancing in the first place. This weekend we’re finishing up Ciara’s Gimmie Dat, one of my favorite songs-of-the-moment (the video’s choreography isn’t as good as Vera’s). I’m always impressed with the ability of good choreography to translate energy, emotion, and passion from individual movement and isolations to an entire crowd of people.


Since I didn’t get to wear Ciara’s awesome A-town hat in our video, I’ll post this picture instead.

Our brains aren’t wired to work in logical systems. Design is just as disorderly as life. Composing photos, creating a desk, and a choreographing a hip-hop class can teach us something about uniting human needs with systems capabilities.

the little things on my mind

It’s Sunday night and I’m spent.

It’s the kind of weekend that’s spent working on the little things. So often we wait for the big things that will define us - a degree, a particular job title, a promotion or a product launch. But life isn’t lived in the big things.

I got an email earlier this evening from a friend of mine (and I hope he doesn’t mind that I quoted this):

”[…] i’m glad that you post. particularly with the material that you do because if you tried to share this information on an individual basis, i might never have heard you “talk” about all the things and topics that you blog about. in fact, your blog actually helped me refine my “public health” eye to include a design element. plus your references to various books and articles inspired me to read them too and find ways for them to relate to my work and passions. […] 
so basically, thank you for blogging. i know it’s hard but i’m glad that you do.

It’s a small thing, and I get a fair amount of emails about the blog, but it made a difference. In a world of big things, a small thing like a thank you can change everything.

Lehrer writes,

“This is life as it’s lived - our epiphanies inseparable from our chores, our poetry intermingled with the prose of ordinary existence.”

If we live intentionally, we design our lives to take care of the poetry. But in doing so, we sometimes forget to appreciate the beauty of the prose.

So tonight, some snapshots of life’s ordinary moments as they’re lived - small celebrations among the chores.


I laugh at this at least once a day. The line about dry cereal? So true.


A small tradition that’s still going strong. Better Than Ezra at Center Stage.


Sawra making friends on our weekly pilgrimage to the Piedmont Dog Park.


A little part that’s a big part of my life right now.


A little space in a cab with seven others.


The simple joy of using fat Sharpies vs. skinny Sharpies. You know you know what I’m talking about.


Sometimes the little things are actually really big things - wearing the insanely huge ACC championship ring, looking far less cool than the owner.

 I was babysitting the little cousins on Friday night, and we happened to be watching Cartoon Network. I wondered aloud why in the world they show human tetris on Cartoon Network, of all channels, when my 8-year-old cousin piped in, “People like to watch other people get smushed by foam walls and pushed into pools of water!”

Yes, sometimes, it’s the little things in life.

designing cradle-to-cradle

In honor of Earth Day, a question: for any of you in [product] design, who generate physical things as a result of your work, have you ever designed anything to be cradle-to-cradle?


Chicks dig recyclers (true story). World of Coca-Cola, Atlanta, Georgia.

As in, something that can be completely repurposed and completely diverted from the waste stream?

It’s a difficult proposition in medical devices, because of biohazards and body fluids, but I’d be curious to see some good examples of how, in this age of smarter consumption, designers are coming up with smarter creations as well.

On another note, I’ve posted three times in two days! That’s got to be some sort of record or something. I’ll take a cookie for that.

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