INTERSECTION OF DESIGN & MEDICINE
P
A
s a freshman at Auburn University
in the late 1990s, I took an Appre-
ciation of Architecture class, hop-
ing for a fun and engaging time to
counter the rigors of our pre-med
curriculum. Professor Stephanie
Bothwell challenged our class, not
on memorizing and identifying architectural
styles or historical points, but on understanding design and the
effects of good and bad design on our daily lives. She challenged
us to walk, counting paces, across streets in historic, walkable parts
of Auburn and then contrast those streets with walks across more
suburban streets on the outskirts of town. We were tasked to draw
scaled cross-sections of our walks, then write about how those
areas made us feel. We closely observed neighborhood function-
ality, modes of transport to, from and through, and opportunities
for human interaction. Furthermore, we were challenged to create
better design for the things we saw as wrong in our environments.
She invited us to speak passionately in class about what we valued
in our built environment. The class, for me, was eye-opening, life
changing, and helped me place, in more concrete terms, some of
the design issues and limitations I had identified in my own sub-
urban upbringing. More broadly, I began a quest to understand
and appreciate design, not just in the built environment, but in all
facets of life and practice.
Fast forward 25 years to where I stand now, practicing medicine,
and I see the benefits of good design and, sadly, too often the detri-
E r, MD
C
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olte
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ments and limitations of poor design in my patients’ lives. Design
may not be the first skill considered in medicine, or in those who
practice it; medicine is often considered a more empiric and pre-
cise discipline. However, to quote author Alina Wheeler, “Design
is intelligence made visible,” and design is an indelible part of our
science and our art. We, as physicians, are taught to embrace this art,
the “art of medicine.” Good design complements the plans we create
for our patients. Good design is at the heart of the academic study
we use daily in our practice. Good design enhances our treatment
plans and the chances of achieving favorable outcomes. Yet, bad
design hampers our success in patient care and, frankly, stands as
a roadblock to the success of our patients.
In this issue, we endeavor to take a brief, but varied, look at
the intersection of design and medicine across time and place. We
look at selections from the human interpretation of nature with the
Vitruvian Man to more pressing modern-day issues of urban design
and transportation, office design, and the ethos of the hallowed white
coat. More broadly, we hope this issue opens up new horizons for
you, our colleagues and readers, to consider the complex interplay
of our physical, social and interpersonal constructs on our daily
interactions with patients. I hope, much as I experienced those
decades ago at Auburn, that by considering the more traditional
bastions of creativity, you will enhance your own ability to construct
plans for the good health of your patients, by design.
Dr. Kolter is a practicing internist with Baptist Health.
MARCH 2020
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