Keith,

I hope you get well soon.

Best wishes,

Paul



On 22 Sep 2011, at 00:48, "Keith Russell" <[log in to unmask]> wrote:

> One can look at the differences in process and also locations in various disciplines, some of which claim creativity as a defining or describing feature.
>
> Art and design after often treated as studio based disciplines. Many years ago I raised a model of theory making as a studio based activity.
>
> Recently, it has come to my attention that one might also treat an area such as the medical environment of the Intensive Care Unit (ICU) as an example of a studio practice within a discipline.
>
> Having recently spent a few days in an open heart surgery ICU, I had time, in between routines, to watch how things happen.
>
> Case studies are limited in their uses and this one is quite limited in its uses but the story would seem to me to be worth the telling.
>
> The first thing that got my attention about the ICU being a studio was the control stations for each patient. Each patient had a A1 drafting table complete with high stool. On this table was an A1 sheet with all the data for that particular patient. Nurses and doctors would sit at these tables for long periods either adding new information and/or analyzing in what these figures meant.
>
> Beyond these tables were long benches with various other information devices. Such things as x-ray screens. On my final morning in the unit I was awake enough to see the shift changes and to see the new Chief Medical Officer (CMO) take over. He went from the benches to to the drafting table and back. He checked and re-checked data. He was massively intense and I was the person he was being intense about.
>
> So far he hadn't actually approached me. His analysis was abstract. He had a plan but before he carried out his plan he started to look around the ICU - he was searching for the young trainee physiotherapist - a gentle natured female. You could see the look of a master (teacher) in his eye. How was he going to make this an educational moment? He called her over and asked her to examine my lungs using a stethoscope. So far he had not listened to my lungs. They both listened together. He then took her across to my x-rays and he asked her to show him, on the x-rays, what she had just heard. Of course, she found this difficult. He started off simply, in a Socratic way, and progressively, he got her to see what she had heard.
>
> So now the student could see what they had previously only heard. The CMO didn't have to listen to know what the charts said and what the x-rays explained.
>
> The next stage in the cycle came when the surgeon arrived. The CMO had his own ideas of how to proceed, the surgeon had different ideas. For the CMO the evidence implied an intervention was required, here and now. For the surgeon, things could wait until later because maybe the lung issues would sort themselves out.
>
> In the long run, the CMO was right and he had to leave the ICU to perform the intervention on the ward. The CMO's model was the better one in terms of the ICU studio.
>
> For the CMO the ICU is a studio. He gets patients who have undergone radical surgery. They have known conditions brought about by surgery. They have expected pathways of recovery. There are numerous milestones along the way. There is a huge amount of data. There is a desired outcome (leaving the ICU in a stable condition). Also, there are many unknowns and complicating problems that must be solved if the best outcome can be achieved. Balancing these many requirements is a skill, an art, and a creative practice.
>
> I feel a lot better knowing such masterful CMOs practice in their studios day in and day out.
>
> cheers from a recuperating keith