The Sounds of Healing: How Hospitals Can Get Less Noisy

This morning, I was up at 4:00 a.m. practicing for this stage when my phone started to ring. It was one of my friends, my oldest friend in the States.

He has been in and out of hospitals for the last few years with a rare form of leukemia. He was calling to let me know that he had just been told he had one more week.

He really likes music. He used to come to many of my shows. We would go to clubs. He’s into techno music. We danced together.

I’m thankful for this community today because it allows me to feel safe enough to acknowledge that I’m not very okay right now. It feels like there is something more pressing to say than this prepared talk, but I’m not confident enough to improvise an entirely new one.

So I’ve decided to stick with the presentation I prepared for you today. I’m going to give it my best, but for the next 15 minutes or so, I wonder if I could ask for your support.

Thank you.

We had our final conversation this morning. We said goodbye to each other six hours ago. It’s tough.

Two years ago, I was invited to speak at the first End Well Symposium and share my experience as a sound artist who had spent time in hospitals as a patient, disturbed by noise.

I used to wonder whether the last sound I would hear might be something like this.

[Hospital alarm sounds]

Lying in a bed, I would close my eyes and dream of soothing, peaceful sounds.

Some people say hearing is the last sense to remain when we die. So what would I get to hear?

I created a piece called “The Sound of Saturday.” It is the sound I have never heard but have always imagined.

[Sound piece plays]

When my illness began several years ago, I used to make lists of things to do because I was a Type A person.

A list of doctors to see. A list of medicines and supplements to try. A list of tests to take. A list of books to read about my condition. A list of different therapeutic modalities. A list of special diets.

I was convinced that once I crossed everything off my list, my symptoms would disappear and I would return to my normal life.

Things didn’t quite happen that way.

As I became more desperate, one of my clinicians told me, “Maybe the next thing you should put on your to-do list is being okay with the possibility that you won’t cross anything off it today.”

The next thing on the list was to feel safe with the idea that I might not get better.

To feel safe.

What I hadn’t realized until that point, and I don’t even know whether this will make sense to you, was that I had never really known how to feel fundamentally safe about anything in life.

This crisis in my health allowed me to see something I hadn’t even known I had been missing my whole life. Feeling safe is part of feeling human.

I think about that more and more in everything I do lately.

Illness has a way of shaking us at our core. Even when I unexpectedly began to improve, my life never returned to what I had considered normal.

This part of my life feels like a lucky bonus. It doesn’t feel normal. I sometimes forget that and try to do things like transform the sound environment in hospitals.

Two years ago, I shared the beginning of this journey to rethink the sound experience in hospitals. People often ask what has happened to those ideas since then, so I’d like to share an update.

Since then, curious designers and engineers from medical device companies have reached out to begin conversations. We have collaborated with some of them to create more considerate sounds for machines, ranging from a classic home-care heart monitor for people who aren’t comfortable with technology to a new medical device that has never existed before for people who love technology.

I love this wide range of opportunities because it broadens our spectrum of empathy.

I also visited the headquarters of medical device manufacturers to share stories from patients, caregivers and clinicians about their experiences with sound. I talked about the most disturbing sounds they remembered hearing and the final sounds they would want to hear.

Then I asked the German engineers what final sound they would want to hear.

They told me, “We usually have speakers who talk about numbers and metrics. We’ve never had an artist in our building talking about emotions.”

I had never been inside a building where machines were being assembled by actual human beings. Somehow, I imagined that machines came out of other machines. But there are human beings, just like you and me, behind them.

That day, the users of those machines became a little more human to the engineers. But the engineers who made the machines also became more human to me.

It was the beginning of an unexpected friendship that has become very profound.

I also discovered that there often isn’t an easy way for the people who hear these sounds, the beeps and bloops, every day on the front lines to participate in the design process or have a say in how the alarms sound.

Many of them say things like, “I never felt I had permission to say that I don’t like those sounds.”

To me, the design challenge surrounding alarms is less a technological problem than an issue of inclusion.

We need to consider the functionality and safety of alarms, along with the subjective experiences of everyday people and how these sounds affect us.

For people to participate in the design process and freely share their emotions and feelings, the process must make them feel safe. It needs to be fun and playful.

We decided to call this participatory design process “Beepers and the Beeped.” Beepers are the people who make the beeps. The beeped are the people who get beeped by them.

What happens when we connect them through empathy?

[Video plays]

Have you been annoyed by alarms? What if you could lead the change? Join the conversation.

You get to press buttons and hear these sounds. You get to answer questions like, “How do these sounds make you feel?” and “What would you change about them?”

We begin with simple questions such as, “What sound did you wake up to this morning?” We listen to these sounds and use them to imagine the future of hospital soundscapes.

It’s a lot of fun.

We took the process on the road and met even more beeped people, including younger people and stakeholders from many different institutions, along with our beeper friends.

“Beepers and the Beeped” is a participatory design framework in which the people who design medical device alarms and the people who have to hear them can have human conversations.

It’s simple, right?

The goal is to make these sounds safe and functional, but also sensible, kind and respectful during the most vulnerable moments of our lives.

We are now speaking with a group of passionate and caring engineers and designers involved with one of the most widely used medical devices.

We recently discovered that sounds still heard in many hospitals and intensive care units today were created on this synthesizer in 1981, before many of us were born. Those sounds have never changed.

I often think about all the moments these sounds have surrounded during the past 40 years: lives being saved, lives being lost and new lives being born.

I think about all the people who have served in healthcare for decades, walking alongside these sounds.

Suddenly replacing them with something completely different would be unsafe. It would also be uncompassionate because people have become so accustomed to them.

We have to change them with people.

That means working with more than a focus group of 20 people. We need hundreds of people who represent the diversity of our experiences, from emergency rooms to palliative care units.

We should involve patients and caregivers. We should include people from other countries. We should do it together.

This can be the beginning of transforming the sound environment.

I hope you’ll join our growing family of beepers and the beeped. And next year, I hope we have the funding to do it.

Thank you.