Practice to Voluntarily
Harry Jinwook Seong
Having exercised the profession of General Practitioner for several years, we have recently witnessed the emergence of anew profile of voluntarily mute patients, awakening our curiosity about their origins.
Being confronted with a patient who does not express himself with words or sign language is incredibly unusual. The resulting adaptation then calls into questioning all long-established auscultation and diagnostic practices.
Through this research thesis, we will explore the potential evolutions that can be envisaged in the practice of general medicine, first by researching the origin and lives of the “Voluntary Wordless” community, then by studying adaptation and its compromise, and finally, the consequences of this way of living and its limits.
on the Wordless Community
A) The origin, beliefs, and values of the
Voluntary Wordless community.
In order to understand the “VW” ways of communication and learn as much as we can from their culture, we immersed ourselves in their community. We were also lucky enough to be in touch with their Interpreter*.
This small community is defined by a refusal and rebellion of the language in its conventional form; words.
According to their Interpreter, «they rebel against social media being a memorial of what they’ve once said and people’s interpretation being their trial. They reject the loneliness of being unable to express emotions and experiences that cannot be understood fully and correctly through words. They want to let go of language borders that keep them away from other human beings. They rebel against the human instinct to define and categorise all things with words which flatten experiences and reality into abstract symbols with infinite connotations. They are tired of a society where the choice of words becomes more important than their meanings and what they are trying to communicate.»
Having let go of words «for their imperfection as a tool of communication», they have created contextual languages for a universal access.
Removing a layer of communication thus seems to allow them to reinforce relationships between them but also connect with their surroundings, «having a more real and “raw” experience of the world.»
They practice activities more connected to nature and energy, focusing on concrete and physical ways of understanding others and connecting with them. These types of professions mainly include artists, dancers, musicians, yoga teachers, masseurs. They also perform activities that are more reliant on physical labour or an understanding of natural or mechanical processes. Examples of this could include farmers, gardeners or architects.
Regarding our field, they have emphasized alternative ways of practicing medicine such as naturopathy, homeopathy, acupuncture or traditional medicine. In other terms, spiritual practices which demand less verbal communication, adopting methods easily adaptable to their way of living.
*Interpreter is a profession within the Voluntary Wordless Community aiming to adapt verbal language into a wordless one. Living outside of our society, they eventually wish to become independent and self sufficient, in order to no longer need interpreters and detach themselves from all verbal form of language.
B) How they interact with their surroundings and one another
Having interacted with VW patients, we quickly understood that they put an emphasis on the present and what surrounds them.
Objects, visuals and their senses seem to be the main point of connection and understanding of each experience that they have. They seem to have recognized this, and design ways to accentuate the importance of these things. With the use of various technologies, they give sounds to other objects, amplifying their existence and importance, and allowing them to speak. One set of objects we were able to interact with in our research and pursuit to understand was a set of drinks whose cups were modified to create sounds when picked up or touched. This created a greater sense of importance for these objects, and was a simple way in which they could acknowledge the importance of the objects which unify them. The cafe became more of a shared experience. In other cases, the senses are mixed together to create a more holistic experience “giving rise to a multi sensorial universe, with ambiguous yet beautifully understandable ways of sharing an experience” according to the interpreter.
C) Films: as a tool to understand the mindset of the VWordless
In order to understand them better, we viewed short films from this community. This allows us to access part of their of the world, giving us a better understanding of their mindset, translating the world of words into a world of confusion, breathy gasps, human emotions, touches and visuals.
An interesting aspect was to see how this community experience and analyze historical events. Since they remove words from books , magazines, TV programs and radio they analyze historical and current events without the weariness of words, the chaotic connotations and opinions. The interpreted showed us a filtered version of Suzi's speech.
Another interesting aspect was to see how this community experience cinema. In a more abstract and poetic way. They seemed to put an emphasis on visual experiences rather than the language that comes with it. The cinema becomes a place that can easily represents the Wordlessness Community’s values and beliefs perfectly.
In order to understand how the ZAO experienced the context of medicine we created a short film of our own of a GP session so we could begin to understand how the community might place itself within that context. What would they understand and what are the problems that would occur? This further enabled us to understand the challenge this community faces in the context of a doctor’s visit.
The VWordless in the context of a consultation
More and more members of the VWordless community came to our practices bringing objects and new ways of expressing their illness to us. Understanding how they feel and diagnosing them has been quite a challenge. There can be quite a lot at stake at a doctors visit, especially when a patient is in discomfort because of their symptoms or unsure what is going on with their body. In trying to express and understanding these things without language, tensions arise. In order to extend our practice beyond language, we had to look at new ways of understanding patients, expressing diagnosis, and prescribing medicine.
A) How can a patient express their symptoms
The VWordless came to our “offices” with what we call “symptom objects” in order to express the sensations they are experiencing.
These patients each came in with what appeared to be hand-made objects that represented the way they feel as tools to help them express themselves. These pillow- like objects were made by the patients themselves, and so they were being generally by individuals. This meant that the objects were quite easy to make and modify, and could theoretically be adapted and created by anyone to express their symptoms.
The effect of the symptoms seemed to be expressed mainly through the textures felt in the pillows depending on what they were filled with or how they were modified. Some objects were very simply stuffed with a household object, one example being aluminum foil” which was held up to the throat and felt in order to express a dry, scratchy throat. Another more technologically advanced example contained a vibrating motor that was used to emulate the pulse of a fast heart-beat. To try to describe what these objects express defeats their purpose, but they were wide-ranging and malleable in their construction.
However, we felt there were gaps to be filled in what these objects could express.
To expand on what these objects could be used for, we created some aids ourselves to encourage further ways of expressing the symptoms. We made a set of cones that trigger sound samples that can be modified by the patient. This allows patients to create their own sound of their pain and identify and express other aspects of their experience, things such as a heavy aching, a lingering sensation, or how long pain lasts. We modified the pulsing vibrating pillow to have a knob to allow for adjustment, allowing it to be reused in different applications.
Wordless patients can combine and create their own objects and sounds to express their individual symptoms.
B) How do we diagnose and express what we see as practitioners
Regarding our practice and how could we share and explain what we are seeing, we started building some new tools. This was an attempt to find ways to unite the patient and the doctor without relying on words in order to explain what is being observed.
The stethoscope is the first prototype we developed. By iterating the original stethoscope and making it a shared audible experience for the patient and the practitioner the device becomes more understandable, and words less necessary. This experience remains intimate, as the doctor and patient must stand close to one another when using it. Possible other iterations allowed for the stethoscope to generate sound or play on a speaker, broadcasting the heartbeat to the room.
We’ve attempted to design an otoscope to be inclusive as well. One possible version is an otoscope that uses reactive material to create textures based on what appears in the lens. This would allow both the doctor and the patient to be able to physically feel the shapes of what is being detected and observed. Another otoscope is connected to a projector that displays what is being seen by the doctor on a screen. This example is more practical but less intimate. These tools could be applied in a dental health context as well.
C) How do we prescribe and distribute medicine without relying on language
In order to understand which medicine the VWordless has to take, he iterated the medicine box for his better understanding. To create understanding, there is a code embedded in the packaging. Each medicine container is covered with a fabric pocket that contains textures from the symptom object pillow to remind what the medicine is treating. The color of the fabric pocket and portions of the box signify what time of day the pill must be taken, corresponding to the colors of the sky during day and night. Each box contains the medicine for a single day. This simplification and use of simple codes allows the wordless patient to avoid the pitfalls of conventional language and still take medicine.