There are several ways to learn, and one of those ways is the hard way. Recently Diana Spellman, a well-known interior designer and president of Spellman Brady & Company, completed a two-year journey as a patient herself, battling breast cancer. Enduring six surgeries, many months of chemotherapy, and radiation, she truly experienced what patients need in their healthcare environments. It's not just stylish furniture and fine art, but how existing environments contribute to the excellent healthcare delivered within them. In a wide-ranging and frank discussion with HEALTHCARE DESIGN Editor Richard L. Peck, Spellman described her hard-won “education” and how it will shape her future projects.
Richard L. Peck: What was the basic patient experience you just went through?
Diana Spellman: Well, to be blunt, there was nothing basic about my patient experience. It was a roller coaster of emotions, shock, fear, anger, and panic that transforms itself into trepidation, anxiety, and sadness, and all the while I was trying to present a strong front for my family, friends, and business. There were many times that I felt as if my entire being was exploding into a million fragments, especially after I found out that I carried the BRCA-1 gene that strongly predisposed me to ovarian/uterine cancer as well.
Anyone who knows me well understands that I am a strong but intuitive soul, one who always has a plan A, B, C, and D. I am highly productive and a survivor by nature. The most difficult part of this experience was the initial unfolding diagnosis. Many times I thought to myself, “I am strong and still feel these intense vulnerable feelings, so what does one feel who isn't as strong?”
Currently, my prognosis is very good. Truth be told, this was not just my diagnosis, it was our family's diagnosis and beyond. Like ripples of waves, it touched many people and situations in my life. Although it has taken a tremendous amount of energy to go through, one way to look at it is that this experience was a gift, because so many good things came out of it-but with a price tag of physical and emotional pain.
The mention of “patient experience” now absolutely resonates with me. And an important fact to remember: any patient who travels through a significant illness or injury carries it with them for a very long period of time. It almost seems as if there is an element of PTSD [post-traumatic stress disorder], as if the memories of the experience continue to ripple to the surface.
Peck: Did you experience any good environments along the way?
Spellman: Not really. But how does one define good environments? These spaces, at times, are subliminal and hard to put your finger on-but oh-so-negative when wrong. The single-dimension physical environment was often polluted with other offenses that overshadowed the experience. My patient care was excellent throughout the journey. I had outstanding physicians, but nearly every environment I experienced could have been greatly improved. I'll give you an example: During my initial needle biopsy, the overhead music was playing, as it happened, the theme song from Romeo and Juliet. I heard this and said to myself, “It's malignant.”
Another example of an environment that contributed in a negative way to my patient experience occurred while sitting half-naked in a hospital gown, being prepped for surgery, in a corridor construction zone. Let's think about the psychological and physiological impact that environment has on patients. In this temporary construction setting, upon being placed in a radiology room to insert some guide wire into my chest, the technician said, “Oops, I don't have the correct supplies; be right back, don't go away.” I thought, “Kind of difficult with wires threaded through my chest to not black out, let alone go away.”
Chemotherapy infusion spaces: While initially I was anxious and fearful, the team of physicians and nurses were comforting and gentle, both emotionally and physically, although many times the message or procedure was painful. The infusion area had dated physical surroundings that did not measure up to the excellence in care. For instance the floors, walls, and ceiling were devoid of any interest-flat, gray-tonal, tenant-grade carpet, light blue walls with silk wreaths for decoration, and recessed fluorescent lighting in the ceiling.