A NEW KIND OF HOSPITAL ROOM 2017

Publication:
New York Academy of Medicine
New York Academy of Medicine

Brookdale-installation
Brookdale-installation

a-new-kind-of-hospital-room
a-new-kind-of-hospital-room

New York Academy of Medicine
New York Academy of Medicine

1/5
Storefront For Art and Architecture with Brookdale Hospital &
New York State Council on the Arts

Abstract: "A New Kind of Hospital Room" 

Since December 2016, in the heart of the notorious neighborhood of Brownsville, Brooklyn, a small group of high risk individuals have come together in a new kind of hospital room. Using big data technology, they identify key data sets within their neighborhood, then parse that data through a methodology of verbal and time based cryptography called a cipher.  As the group zooms in on spaces in the neighborhood, they create a model within that space based in time and elucidate details of that model based on resonant ecological themes. The result is an understanding of big data in a high risk area that hospitals and insurance agencies can rarely glean based entirely on standard methods.  As key, actionable decision makers in the high risk zone of ecological sensitivity - the group of individuals offer key actionable insights. 

 

Because this whole operation is done within a hospital setting, data collected is protected by HIPAA law.  Participants don't risk being a "snitch" through their data analysis.  Rather, by association with the hospital - by far the most powerful institution in the neighborhood, generating millions of dollars annually - high risk participants become powerful stakeholders of neighborhood change. 

Studio Description: "Wilderness and Sanctuary in Brownsville Brooklyn"

The project began as a discussion of "wilderness and sanctuary" in Brownsville.  Participants assessed the meaning of traditional "wilderness" paintings such as Albert Bierstadt's "Indians Spear Fishing," at right.  Rather than a typology of "wilderness" space, the group in Brownsville repeatedly identified the social and psychological mental space of "wilding," which often centered on the concept of being "savage," in which someone would "do what it takes to survive." 

 

In this kind of mental space, or rather, perceived mental void, it is possible to become violent in order to obtain peace, but the emphasis is not on physical violence so much as on transgression of a boundary, either mental, social, or physical, often inter-personally.  Various examples were provided of being forced "up against a wall" with "nowhere to turn" where one had to "wild" and "be savage" as a means of escape. This concept of escape when there is no escape is not to flee the "problem" but to "become the problem" - a moment of radical transgression of mind and body duality with emptiness of mind in which the law and various mental issues becomes embodied by the participant. One "breaks" the law, and in this way, inscribes the law into his or her own body. 

Within our agonistic dialectical society(1,2,3,4), it is no coincidence that this creation of law, by transgression and exception, is the primary means by which law is maintained, interpreted and changed; to "catch a case." It should come as little surprise that within a state that is majority and normatively "white," this transgression is so often embodied by "black" people in namely "minority" neighborhoods - witness to the agonistic dialectic of American culture.  The concept of embodiment of socio-cultural ecological trends within minority, particularly marginalized populations, is subject of Nancy Krieger's "ecosocial theory,"(5,6,7) as well as creative starting point for ecosocial design.  

This is why ecosocial design is predicated on the gravity of high risk populations and spaces of vulnerability - it is within these spaces and with these actors that majority ecological systems are established, maintained, and adapted.

The discussion on "wilding" led to a categorization of atmospheres that have various effects on wilding.  For example, a complete pharmacology of drugs and alcohol were identified in terms of their affect on social and psychological interaction. Interestingly, drugs were perceived as coming, most powerfully, from mysterious and often wild spaces, whether beyond the walls of a chemical factory, or in a foreign country ravaged by war.  

 

Music, particularly hip hop music, was identified as analogous to powerful drugs, and likewise arises from a potentially violent and wild space. Yet, hip hop is a kind of drug that can be harvested by people in the neighborhood in their own lives, and then distilled locally, in their own minds, before being bottled in the recording studio.   Music is a powerful sanctuary, place of healing, and environment of potential wilding.

Rather than focus on the bottling and distribution of music, as a recording studio, the group decided to focus instead on the process of creation of music in "freestyle cipher" that allows for a deep analysis, a kind of "close reading" of a place, together with a group of people.   In this way, it's possible to understand real time rhythms associated with space - to understand its socio-spatial ecology - and act on it.   The main precedent for this spatial understanding of "urban rhythms" is the previous studios in Brownsville on this subject, most notably the mapping studio conducted in 2015 in which high risk young people mapped neighborhood risk over time.

This became the basis of the "New Kind of Hospital Room" that would function as both as space of "wilderness and sanctuary" and allow for the management of ecological big data by working with the high risk group.   In this way the "new kind of hospital room" moves the data parsing techniques of cipher cryptography into the highly actionable hospital environment.  

19th century notions of "savage" "wilderness" become 21st century realities of spatial social determinants of health. Landscape paintings still are important part of landscape design - see paintings produced by AWED in the design of NYC parks and civic landscapes.

Transition of treatment methodology from removal of transgressor, to group negotiation of psycho-social dimensions of space of transgression through "wilderness and sanctuary."

Psycho-social dimensions of space negotiated through cipher cryptography

Collaborator Tameel Marshall, pictured above, describes how the rapping environment plays with neighborhood data in terms of “beat,” “instrumentality,” and “lyricism.” Essentially time, scale, and meaning in practice:

  • "Beat is the rate or the beats per minute, the metronome, breath, activity in a day, the ability for actions to take place, data, police phone calls, Facebook data, drop-out rate. It is the way slaves would communicate beyond words, the angle of perspective, the power of persuasion. It plays a big role in how something is perceived, whether a song captures the feeling of ‘the street.’

  • Instrumentality is materials, tools, iron, guns, instruments, Google, Facebook, murals, stores, things they sell, garbage, chemicals, food, clothes, etc.

  • Lyricism is meaning, criticism through ideas, words, and metaphors such as lies, African masks, images of the Vietnam war, desires to make it big and get out of Brownsville, etc."

Theoretical Discussion: The Hospital and Hospitality

The practice of health care in this space is not new.  In the Western tradition, both the hospital and the practice of hospitality have developed in the embodied "wilderness" space of transgression.

 

At times both hospital and hospitality overlap, as in the case of the asylum. As Foucault describes in detail in "Madness and Civilization"(8) the development of the modern hospital is staging ground for both reason, unreason, and transgression in which these concepts are tested and adapted on the bodies of individuals.

Beyond the asylum, even something as cleanly allopathic as surgery requires the embodiment of social and mental illness to such a degree that the patient is often locked in a room, restrained in a chair, drugged to a state of stupor, and then his or her body is physically cut and entered into as an object of flesh.  In the hospital, in this sense, the patient has "become the problem" so the that the doctor may enter and change him and in the process extract quite a large portion of the world's GDP  - agonistic dialecticism present on an intimate scale.  Landscape extraction writ ecosocial.

Meanwhile, within the tradition of hospitality and its practice of "entertainment," an effect (and affect) of healing the mind, and with it, the body, is created through mind/body union in transgression.  Albeit, rather than the surrender of mind to body, and the rendering of the self as an object for curing; hospitality is the associative union of mind and body in dynamic practice, blurring boundaries between healer and healed, doctor and patient, guest and host, self and environmental context. 

 

Hospitality and entertainment was identified in the Brownsville group as providing both intoxicating wilderness and peaceful sanctuary simultaneously.  Being "up against a wall" in this sense is a confrontation with potentiality, with the unknown.  This "wall," "screen," or void of unknowing isolates and protects, but also connects and humbles.

A "manual of hospitality" was created by Tameel Marshall and Alan Waxman with the intention of guiding people in this process.  Drawing from concepts learned in America's prison system, the authors decided to describe the philosophical process in terms of the language of the Japanese tea ceremony and zen, in order to intentionally obfuscate the apparent dichotomies of American spiritual and material life. The manual is called "Jimucha" or "self-void-tea."

1. Mouffe, Chantal. (2000) The Democratic Paradox. London, New York. Verso.

2. Honig, Bonnie, (1993) Political Theory and the Displacement of Politics, Cornell Press

3. Charbonnier, Georges, (1969) "Conversations with Claude Levi-Strauss" Jonathan Cape Ltd

4. Adorno, Theodor (1974), "Minima Moralia". London: Verso Editions

5. Krieger, Nancy (1994), "Epidemiology and the Web of Causation: Has Anyone Seen The Spider" Kaiser Foundation Research Institute, Oakland 

http://www.havenscenter.org/files/krieger1.pdf

6. Krieger, Nancy (2004). "Ecosocial Theory". In Anderson, Nathan B. Encyclopedia of Health and Behavior. SAGE Publications, Inc.

7. Krieger, Nancy (2011), "Epidemiology and the People's Health : Theory and Context." Oxford University Press 

8. Foucault, Michelle, (1988) "Madness and Civilization" Vintage