Journal of Sonic Studies, volume 6, nr. 1 (January 2014)Marie Højlund; Sofie Kinch: ALARMING ATMOSPHERES - EMBODIED SOUND HABITUATION AS DESIGN STRATEGY IN A NEURO-INTENSIVE CARE UNIT
5.1 Context & Problem
A daughter of a patient with head injury explains how her mother told her that she thought she died several times while slowly waking up from an unconscious state in the hospital. She later explained that this experience was triggered by the alarm sound from another bed in the shared ward. She associated this sound with that of a heart monitor stopping as she remembered it from movies. (Højlund and Kinch, field notes)
Building upon field work and interviews with patients, anthropologist Tom Rice describes the hospital as a holistic entity with an “unusual atmosphere of sensory absences” (Rice 2003: 5) – caused by the lack of tactile, visual and olfactory, among other, stimuli – leading to a sense of alienation and detachment from the surroundings. These sensory absences often cause the soundscape of the hospital to shift to the foreground of attention, making hearing one of the most important senses for understanding and making sense of the environment. This resonates with statements from the nurses at NIA, in which noise is said to be the main stressor. In initial stages of the research, one of the nurses stated that her biggest wish was that someone would design a noise deflector that could create a private atmosphere for the patients and relatives in the shared wards.
The soundscape of this unit, as is often experienced in modern functionalistic hospitals in general (Frandsen et al. 2009: 71), is dominated by a cacophony of alarms and other functional sounds relevant for specific members of the staff. As they are not relevant or functional for the patients, they become unwanted noise for them. Because the alarming sounds are designed to arouse and attract attention, they are difficult to ignore and resist being shifted to background awareness, and thus interfere with patients’ attempts to sleep, interact, or relax. Combined with other sounds from, for example, equipment and conversations, they form a complex soundscape with many intrusive sounds, intensified by long reverberation times related to the acoustic properties of hard tiled walls and floors. This soundscape induces unnecessary anxiety and aroused body states, counteracts healing and sleeping, and augments the feeling of seclusion and alienation from the environment.
After being prepared through a verbal explanation in the waiting room, two brothers, seven and five years old, enter the ward to meet their hospitalised mother for the first time following her accident. The nurse explains that the two kids feel ill at ease when entering the ward and that “both of them are standing at a remarkable distance from the bed. Neither of the boys moves closer when the mother extends her hand”. The nurse believes that they are frightened and that this is why they approach their mother as a stranger. Afterwards the nurse says that she believes “that this visit was not, by any means, successful for anyone”. (Højlund and Kinch, field notes)
Nurses stress that children brought to the unit must be meticulously prepared in the waiting room for what they are about to experience, in particular concerning the many alarming sounds in the ward. The sudden shift in atmosphere from waiting room to ward often becomes an obstacle for an engaged meeting with the relative. The actual change in atmosphere itself becomes the foreground of attention, even though all parties would prefer this to remain in the background. In such a situation, the rhythms of the alarming atmosphere in the ward affect the bodily rhythms of the child, which leads to a feeling of stress in response to aroused bodily rhythms. Our main design challenge has been to find an adequate response to this invisible obstacle between child and environment.