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      Last month, a workshop co-hosted by DCN fellow Susana Cámara Leret and ‘smeller’ Joy Milne, who has the extra-ordinary ability to smell Parkinson’s Disease, was held at the Alt-w LAB to explore ways in which smells encode memories. Attendees used pens and coloured pencils to document on a grid the memories, feelings and words evoked by 8 mysterious smell samples offered up to them by Susana.

       

      Susana prepares smell samples for workshop attendees.

       

      As each sample was handed to workshop attendees, they were reminded that smells are multi-layered: at first they may be offensive but keep taking the smell in slowly and they might find they change quite a bit. From human sweat to plant pheromones, molecules can be found in the composition of many everyday smells. As we establish associations to these, experiences from the medical setting might extend beyond the walls of the hospital, calling for other articulations in matters of care.

       

      Joy ‘The Sniffer’ Milne has the ability to smell Parkinson’s Disease

       

      The group talked about smells that brought on memories of old workplaces, a GP’s office, being on a farm as a child and those that evoked an emotion or the strange sensation of knowing a smell but being unable to conjure up the word to describe it. Seaweed, petrol, sweaty feet, garlic, cumin were some of the words attendees used to describe the 8 mystery smells. At the end of the workshop, everyone learned what they had been smelling all along: molecules found in types of human decay.

       

      A workshop attendee documents his memories and thoughts after smelling each sample.

       

      The aim of the DCN fellowships are to promote and highlight the working activity and research interests found in the DCN through a programme of dynamic art and science commissions. Development of work using current research practices is key to each fellowship in the programme. The fellowships seek to build relationships between artists, staff and external research partners to demonstrate best practice and contribute to dialogues about the benefits of creative practice in clinical environments.

      Image of Susana Leret

      Exploring ways in which smells encode memories, Susana Cámara Leret’s focus during her DCN fellowship is on experimenting with organoleptics: the involvement of the sense organs in medical settings and considering ‘health ecologies’ through stories of aspirations. Susana started her work by spending time with neuroscientist Norman Dott’s case notes in the Lothian Health Services Archives. There she uncovered stories from DCN in the 1920s and 1930s, when smell was referred to as a symptom, for instance olfactory hallucinations or varying smell abilities between right and left nostrils.

      Susana has also spent time with Consultant Neuroradiologist Dr Pete Keston who told her about a medical intervention, embolotherapy, which is the intentional blockage of an artery to control or prevent hemorrhaging. A liquid agent called Onyx can be used in embolotherapy and when it is, the patient will have breath with a very distinct smell which can last up to a week. On investigation, Susana discovered that as the body breaks down the carrier substance used to carry Onyx to the brain, it produces a molecule that is expelled through breath. This same molecule has a natural occurrence: the key signalling cue of the Dead Horse Arum Lily, a giant flower that smells like rotting flesh.

      Susana is now exploring molecular landscapes- invisible elements we sense through smell- and the associations we might apply to them to ask: How might experiences from medical settings extend beyond hospital walls into people’s homes and vice versa?

      Other articulations in matters of care

      Susana recently carried out a series of smell-memory sessions with doctors, nurses and hospital staff using cards that had been impregnated with the smell of Onyx. Doctors mentioned having a garlicky taste in their mouths after handling Onyx and nurses talked about knowing an Onyx patient had arrived in the ward because the smellscape had been changed so much by the agent. One nurse said the smell of Onyx reminded her of playing by the sea as a child while another said she could no longer cook asparagus because the smell reminded her of unpleasant experiences on the ward with Onyx patients.  

The molecule found in the smell of Onyx is produced by some sea algae and also when certain vegetables like asparagus are cooked. Illustrating the hyperlinked nature of smell, these stories bring into question how we think about and address medical environments.

      You can see Susana’s work as part of the Thought Collider collaboration exploring substances, spaces and processes of affect at Alt-w LAB, City Art Centre, 2 Market Street, Edinburgh until August 27th.

      A number of projects on the ATD programme have a focus on linking the histories of the existing hospitals to the new building. Here we hightlight two of these projects, Old to New and Lightboxes.

      Old to New

      The focus of this project is to share the identity, history, and stories of the three institutions as they undergo a transition from their original sites to the new building. A series of display cases will be installed throughout the building to showcase new pieces that re-imagine the past. Researcher Emma Dunmore explored the archival and historical material available and Kate Ive has evolved the project into a series of sculptural artworks which reinterpret the histories and stories of the hospitals. Cabinet maker Joachim King is making the frames into which the artwork will be inserted, allowing for exploration of histories in bite size chunks.

       

      Image from Lothian Health Services Archive of a radiologist in heavy lead suit.

      Copy of an image from Lothian Health Services Archive of William Law, pioneering radiographer in his x-ray suit.

       

      Kate Ive is working with lead to re-imagine x-ray suits from previous times.

      Lightboxes

      New artworks are being created by Emma Varley in response to an original stained glass piece at the current RHSC. The new work will be displayed in the form of lightboxes and will keep a strong link to the original work, though reinterpreted. The new work will be tailored to the design of the new hospital. The existing nine panel piece is

      a stained glass window which is vibrant, detailed and contains areas of text. It has a rich history attached to it and contains a narrative both of the history of the RHSC and of fairy tale characters. Through drop in workshops at RHSC, patients, families and staff created projected light collages using acetate, translucent papers and found objects which will influence the final lightbox pieces.

       

      Images of light collage creations from drop in workshops at RHSC.

       

      Personalisation is a core element of all of the projects in the ATD programme. All the artists working on the programme have a focus on creating safe non-clinical environments and enhancing them with colours and patterns to create an an environment that is patient focused. Enagement and participation with patients, staff and families is an important step in creating these patient centered environments.

      Created by children and young people from CAMHS, the patterns below were made during printmaking workshops hosted by National Museums Scotland (NMS) and led by artists Sophie and Katie Orton. Taking inspiration from objects in the NMS collection, a selection of these patterns will be seen in the new unit for CAMHS.

       

       

      Extensive engagement and involvement activity carried out by Projects Office with CAMHS patients and families to inform the interior design of the new building means the look and feel of the new unit will be person centered and reflective of those who use the space. When asked during engagement sessions, ‘What does good mental health feel like?’ most people responded, ‘The seaside’.

       

      Excerpt from wall graphics for circulation areas in CAMHS

      Engagement with the general public and with patients, staff and families in hospital has helped illustrators, interior designers and graphic designers embark on a large scale wall graphics project. The new hospital will feature new wall graphics throughout, all of which have been inspired by the stories and imaginations of people in Edinburgh.

      Artists Rachel Duckhouse, David Galletley, Alison Unsworth and Natasha Russell are taking the public’s contributions and turning them into wall graphics you will see throughout the entire hospital. Lead artist Alison Unsworth creates detailed drawings about a variety of things including landscape, built environments and wildlife. Rachel Duckhouse creates abstract, geometric artwork with colour, line and form using hand drawing and printmaking methods. David Galletly creates monotone and coloured line drawings with a graphic and cartoon-like style and his varied subject matter includes buildings, cityscapes, trees and humorous characters. Natasha Russell creates designs using printmaking, painting and drawing methods and her work is focused on landscapes with narrative details.

      Extensive staff consultation and involvement of staff at DCN to inform the design of new waiting areas has led to the commissioning of new medical illustration posters which will be created by Annie Campbell. Acting on feedback that complicated medical treatments and processes can be difficult to communicate, the new posters will help staff communicate with patients and families in a visual way.

      In general, communicating and receiving information in better ways has emerged as a priority for both staff and patients. As a result of this feedback, DCN waiting rooms will feature ‘information walls’ on which posters and leaflets can be displayed in ways that are less cluttered and more accessible than in existing waiting rooms.

      Visualisation of one of the proposed DCN waiting areas. Image by Dress for the Weather

      Visualisation of one of the proposed DCN waiting areas. Image by Dress for the Weather

      From beautiful wall patterns creating comfortable and non-clinical environments to posters communicating complicated information, new interiors have been influenced the people who will use them. Work will continue over the coming weeks to finalise designs in the run up to installations over autumn and winter. Keep up with developments as they unfold on Twitter, Instagram or via our regular email newsletter.

      Language and Cognition fellow Gavin Inglis

       

      We recently spent some time catching up with Department of Clinical Neuroscience (DCN) Language and Cognition fellow, Gavin Inglis. The DCN fellowship project aims to promote and showcase the working activity and research interests currently in DCN through a programme of three arts/science fellowships curated by Mark Daniels. The Language and Cognition fellowship’s aim is to work with people with neurological conditions to explore areas of growing understanding and connectivity between the patient experience and scientific research practice. The resulting work will reveal some of the complex narratives found in the DCN and its partner organisations.

      Gavin has a technical background and has a history of studying artificial intelligence and its possibilities in creating interactive fiction. A keen fiction writer, Gavin eventually came to realise he’s more of an author than a technologist and started thinking about creating interactive fiction that has a chance to make a difference. One such project is an online interactive fiction called Hana Feels. Hana Feels allows readers to navigate through interactions between Hana, a young woman who self-harms, and various people around her. The main purpose is to help readers consider how they might have a conversation with someone they suspect is feeling vulnerable. In creating the story pathways for Hana Feels Gavin says, ‘I thought about how awkward people feel when they have conversations outside their comfort zone. And talking to a friend or family member about their self-harm certainly falls outside the comfort zone for most people.’

      ‘I want to make something useful.’

      Gavin brings this same care, consideration and empathy to the Language and Cognition Fellowship. After spending time in the Lothian Health Services Archive, Gavin has been studying old building plans, records and stories to help him understand the history of the Department of Clinical Neurosciences and one its pioneer founders, Professor Norman Dott.

      Thinking about bringing cognition into his work with language, he is currently considering some interesting areas for development like:

       

      • Drawing from stories of patients with Functional and Dissociative Neurological Disorders (FND). After connecting with Consultant Neurologist Dr Jon Stone, Gavin has become fascinated with FND, a neurological movement disorder that means the brain doesn’t send and receive messages accurately and which is not fully understood. Symptoms of FND can present as a range of motor or sensory symptoms in the body such as weakness, movement disorders or blackouts but it’s difficult to diagnose and some patients have experienced accusations of malingering before a diagnosis has been made.
      • Creating from the writings and stories of Professor Norman Dott, whose 40 years of neurological case study notes (around 26,650 notes) have been recently archived and catalogued. Gavin has been especially taken with stories of Professor Dott himself, by all accounts a unique man who, in the early days of his career, recklessly sped around Edinburgh in his car to attend to accidents…caused by cars.
      • Explore ideas around spatial relationships, how the hospital building plans might reveal spatial relationships and help him to imagine telling stories about how a place may have felt in the past.

      ‘The incredible amount of thought going into the hospital is exciting.’

      After spending so much time in archives and by starting to forge relationships with medical practitioners like Dr Jon Stone, Gavin feels more confident now in speaking to staff and specialists. The next phase of Gavin’s work will see him spending more time with people (staff, patients, families) and settling into a new studio and collaboration lab in Edinburgh’s City Art Centre. Inspired by his fellowship research, Gavin has been creating additional pieces of work like an upcoming Unbound event at the Edinburgh International Book Festival and mapping ideas for further exploration like a game that can help neurology patients in recovery.

      To keep up with Gavin’s progress and all news from Beyond Walls, subscribe to our email newsletter which is delivered every week.

       

       

       

       

       

       

       

      Alex Menzies, music fellow, presenting early research findings with collaborator, Florence To. Photo by Chris Scott

      Alex Menzies, music fellow, presenting early research findings with collaborator, Florence To. Photo by Chris Scott

      The DCN Creative Research Artist Fellows recently gave a talk at the National Museum of Scotland. Around 100 attendees came to listen to the three fellows discussing their working activity and research interests which involve dynamic arts/science collaboration. It was the first time that Gavin Inglis (Language & Cognition Fellow), Alex Menzies & Florence To (Music Fellow) and Susana Cámara Leret (Design Fellow) spoke publicly about their initial findings and approach and was followed by the opportunity for members of the audience to ask them questions. Further information on their activities will follow over the course of the year.

      Audience listening to research proposals at National Museum of Scotland. Photo by Chris Scott

      Audience listening to research proposals at National Museum of Scotland. Photo by Chris Scott

       

      From left to right, Gavin Inglis (Language and Cognition Fellow), Alex Menzies (Music Fellow), Florence To (Installation artist, collaborating with Alex Menzies), Susana Camara Leret (Design Fellow), Prof Peter Sandercock, Emeritus Professor of Medical Neurology at The University of Edinburgh. Photo by Chris Scott

      From left to right, Gavin Inglis (Language and Cognition Fellow), Alex Menzies (Music Fellow), Florence To (Installation artist, collaborating with Alex Menzies), Susana Camara Leret (Design Fellow), Prof Peter Sandercock, Emeritus Professor of Medical Neurology at The University of Edinburgh. Photo by Chris Scott

       

      Audience listening to the panel discussion at National Museum Scotland. Photo by Chris Scott

      Audience listening to the panel discussion at National Museum Scotland. Photo by Chris Scott

      DCN staff meeting the Fellows for the first time during their lunch break at the existing hospital. Photo by Chris Scott

      DCN staff meeting the Fellows for the first time during their lunch break at the existing hospital. Photo by Chris Scott

       

      DCN staff kindly gave up their lunchbreak to speak with The DCN Creative Research Artist Fellows about the plans and possible avenues of research within the DCN hospital. The meeting was a really helpful opportunity to discuss early research thinking and discuss how the hospital operates from a staff perspective, opening up new directions to research and creative thinking.

       

      Susana Camara Leret describing initial proposals to DCN staff. Photo by Chris Scott.

      Susana Camara Leret describing initial proposals to DCN staff. Photo by Chris Scott.

       

      DCN staff were asked to share information about their role within the hospital to help identify potential areas of research interest. Photo by Chris Scott.

      DCN staff were asked to share information about their role within the hospital to help identify potential areas of research interest. Photo by Chris Scott.

       

      DCN staff listening to initial proposals by the Creative Research Artist Fellows. Photo by Chris Scott.

      DCN staff listening to initial proposals by the Creative Research Artist Fellows. Photo by Chris Scott.

       

      Play specialists reviewing proposals for activity stations by Warren Design. Photo by Chris Scott.

      Play specialists reviewing proposals for activity stations by Warren Design. Photo by Chris Scott.

       

      Warren Design recently met with NHS Lothian play specialists to talk about their toy and game proposals for the play rooms and waiting areas in the new RHSC. NHS Lothian staff offer really valuable insight for design teams into what toys and games work within the hospital context and what things might not be as durable or popular with different age groups. Current proposals include giant fish shaped floor cushions and activity stations with a large selection of interactive features.

       

      William Warren from Warren Design presenting proposals for the new RHSC play rooms. Photo by Chris Scott.

      William Warren from Warren Design presenting proposals for the new RHSC play rooms. Photo by Chris Scott.

       

      Play specialist reviewing design proposals by Warren Design. Photo by Chris Scott.

      Play specialist reviewing design proposals by Warren Design. Photo by Chris Scott.

       

      NHSL play specialist listening to a presentation of proposals by William Warren, Warren Design. Photo by Chris Scott.

      NHSL play specialist listening to a presentation of proposals by William Warren, Warren Design. Photo by Chris Scott.

      David Galletly developing wall graphic illustrations at National Museum Scotland. Photo by Ginkgo

      David Galletly developing wall graphic illustrations at National Museum Scotland. Photo by Ginkgo

       

      There is a growing recognition of the value of an enriched environment helping to reduce stress and anxiety and this is placed at the heart of our programme.

      Significant national and international research began with Roger Ulrich and his study in the 1970s, View Through a Window May Influence Recovery from Surgery, demonstrating the positive impact of a considered hospital environment where art and design are integral to the building and to the experiences and health outcomes on staff, patients and families/carers.

      Below is a sample of extracts from published academic papers and government guidelines providing some overview.

      Scottish policy concerning healthcare environments:

      “Health buildings can often be the places in which we may feel at our most vulnerable, whether as a patient, relative or friend. The quality of the building environment that we experience can provide us with calming reassurance or, conversely, it can accentuate our feeling of stress and unease.

      Many factors can contribute to engendering a sense of ease, for instance: the first impression of the facility from the public realm, the entrance experience, the degree of natural light, brightness and airiness, colour and texture, an easily understood layout with clearly defined focal points, uncluttered signage and a clear distinction between the realms of public and private space, maintaining patient dignity.

      The quality of healthcare facilities along with other public buildings and places can be a significant factor in making communities successful.”

      From A Policy on Design Quality for NHS Scotland, 2010

      Qualitative research: End of life environments

      All quotations are from (Kennedy 1999; Forte et al 2004; NHS Estates 2005).

      “The environment should actively demonstrate respect for the bereaved and enable an ethos of support.”…… “It has been suggested that these dimensions of care [attention to the feel of spaces through designs and artwork and a reduction in the clinical] not only have an immediate impact but can also influence the subsequent bereavement process”

      Family experience: “We remember so clearly those last things… it makes a huge impact those last impressions they feature in your dreams….. It’s not just the parents but the brothers and sisters too. It has to be nice, not frightening”.

      Staff experience: “…. if you go down corridors and taking a family down to a viewing room, you would hurry them, you’d be embarrassed about where you are taking them to… whereas if it is pleasant you will relax a bit because you’re proud of what you are going down to, it will be a comfort and care continued from the wards. That makes a difference.”

      Quantitative Research:

      Rosalia Staricoff’s groundbreaking research “A Study of the Effects of Visual and Performing Arts in Health Care, Chelsea and Westminster Hospital” (2003) carried out at the Chelsea and Westminster Hospital, London, measured the effect of visual arts and music on patients and staff between 1999 and 2002. One set of findings recorded that the levels of cortisol a neuroendocrine hormone, used as an indicator of stress in patients waiting for their operation in Day Surgery were lower in the presence of visual arts throughout the day compared to the levels found in patients in the control group.

      “A statistical test was applied to establish a comparison between the responses of clinicians and nurses. The particular environment of this hospital eased their stress levels: clinicians 75%, nurses 60%, and contributed greatly towards a positive change in mood, in 88% of clinicians and 82% of nursing staff. For 96% of clinicians and 91% of nurses the integration of the arts into health care results in a very pleasant environment.”

      Over the next twelve months we will explore some of the areas of this research and how the commissioned Arts and Therapeutic Design programme can help contribute to reduced stress and an enhanced experience for patient users.