A few weeks ago, I saw “Wit” on Broadway. A Pulitzer Prize winning one-act play by Margaret Edson, “Wit” follows Vivian Bearing, a strong, independent, smarter-than-thou professor of poetry, as she faces diagnosis and treatment of Stage IV ovarian cancer.
Under Bearing’s narration, “Wit” tells a story of a patient experience that resonates with anyone who has ever been a patient or visited one. The supporting characters were ones we’ve seen time and time again in any depiction of the healthcare field: the distant physician who litters his dialogue with medical jargon, the eager fellow who’s more interested in the science, and the nurturing nurse who acts as the sole patient advocate. The setting was also recognizable, with bare walls and occasional sounds that echo the general din of hospitals.
The story that captured my attention was the one between Bearing and the hospital. The hospital as the setting and supporting character makes a compelling argument for the importance of the patient’s environment. This, too, isn’t a novel idea but it made me wonder, “What can we do?” What can we do for the spectrum of co-dependent to independent patients so that their experience is less harrowing and isolating?
As Bearing’s illness progresses and her hospital stay prolongs, her need for comfort grows. She explains that with all her shuffling through the hospital for various tests, her room just becomes the next stop. However, her sentiment changes when she actually returns to her own room, “It is such a relief to get back to my goddamn room after those goddamn tests.” Her room becomes a reluctant home by default, the sole source of familiarity in a busy, unfamiliar building.
In another scene, Bearing’s discomfort is measured by her distorted sense of time. Bearing sits alone in her room presumably waiting for something. But in fact, she isn’t waiting for anything; just passing time. She addresses the audience and says, “You cannot imagine how time can be so still. It hangs. It weighs. … If I were writing this scene, it would last a full fifteen minutes. I would lie here, and you would sit there. … If you think eight months of cancer treatment is tedious for the audience, consider how it feels to play my part.”
Recently, hospitals have been adopting a hospitality approach to service and environment, particularly emulating services seen in hotels. While this is in the right direction, it hasn’t quite hit the mark. With some exceptions, hotels aren’t built for people to stay in 24/7. The hotel often acts as a comfortable touch-down after a day of exploration. For this reason, most hotels are built with just the basic amenities to support traveling.
On the contrary, patients in hospitals don’t have the luxury of coming and going as they please. They’re a captive audience. If anything, hospitals should be modeled more after cruises, which are built with amenities to entertain passengers all day. Cruises host numerous activities so that passengers never feel bored or fixate on the fact that they’re on a big piece of metal floating in the middle of nowhere. The analogy isn’t perfect but the concept is comparable.
Leaving the theater, I realized that hospitals shouldn’t necessarily be built to simulate a patient’s home because, let’s face it, there’s no place like home, especially when you’re ill. That’s not to say that creating a comfortable environment isn’t important. But hospitals should also be designed so that time flies by. After all, the patient’s goal isn’t to feel at home; it’s to get home.
Cecilia S. Lum, MHSA, is a Healthcare Consultant at Blue Cottage Consulting.
