Anatomy of Words: Rounds

Interpretive Quilt: Paper, thread, cloth

 

Interpretive Quilt and Rounds explore the group dynamic that takes place when healthcare teams in hospitals communicate at a patient’s bedside. Bratu (2011) says that “organizations are theaters for the constitution of power and all its attendant dramas” (p. 90); a notion supported by Erving Goffman’s (1971) theories on face-work and impression management. These power-performances routinely play out within healthcare teams that comprise various professions and work roles. Both Apker et al.(2005) and Wyrley-Birch (2010) contend that there is a hierarchy within these teams; one that is based on differences in education and tradition in which doctors take the position of highest authority and set expectations for communication. In order for group members to earn the doctor’s respect, they adopt a professional manner which means using medical language to demonstrate their knowledge and detachment. This suggests that although they know that medical language is appropriate for communicating with their colleagues but not with patients, when in “mixed company” during rounds, the group follows the lead of the doctor in choosing their level of language. Further, Thomas & Lee (2010) found that “patterns of behaviour in response to leadership styles have an impact on which languages are valued and the degree to which they are differentially valued by the employees” (p. 99). When a healthcare team opts to use medical language while delivering bedside care to a patient, the patient is left out of the communication loop and unable to access information they need to make decisions about their own health.  

 

Interpretive Quilt attempts to alleviate the language gap between healthcare providers and hospitalized patients. But even with medical terms and their definitions hand sewn onto the patient’s bedspread, there is no guarantee the translations will aid understanding. This is because a patient’s ability to understand is also affected by stress and anxiety, the physiological effects of medication, and unfamiliarity with hospital processes (Stableford & Mettger, 2007, p. 73). The quilt’s randomly blacked-out text and stitches partially obscure the words, showing that it is difficult even for highly-literate patients to grasp important meanings about their health.


In Rounds, the patient—referred to by the doctor as “a case”—receives third-party status during a healthcare team discussion of her medical condition. When the doctor who leads the bedside dialogue uses medical terms such as “emesis” instead of the more widely understood “vomiting,” the patient is further distanced from the conversation. The tattered blackboard background and faded chalk text allude to a communication practice that is out-of-date and in need of attention. The pictographs of the medical team and patient, reworked from medical illustrations commonly used for patient communication and used throughout this exhibition, suggest that despite a title, education, and power, doctors and their patients still share the same human physiology.


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