by the Hospital Senses Collective
‘A curtain is not a door. Confidential consultations hang in the air, a murmuration of medical words. A swallow swoop of numbers and percentages. Someone on the other side speaks Russian – doctor or patient? Spasibo, they whisper. Thank you.’ Sinead Gleeson, Constellations [1]
On the ward, it’s tempting to mistake a partition, a barrier, a screen for an assurance of privacy. With the curtain drawn around the bed you cannot be seen by the others in the room. But it is the same room, and the curtain is not solid. The ‘curtain is not a door’, and sound travels. When crossing the invisible boundary around the patient bed and enclosing it by drawing the curtain, not only is the doctor in the patient’s space, the flimsiness of the curtain means the threshold between private and public has been breached.
Privacy is quickly compromised. Drawing the curtain is an attempt to support privacy and dignity, but a visual threshold is not an acoustic one. When the curtain is treated as a door, privacy can be quickly forgotten. Curtains do not prevent the constant ‘leakage or seepage’ of bodily sounds, conversation, and ‘sonically coded’ medical information. [2]
Gleeson’s symbol of birds is a telling image about the movement of information, which is fleeting, yet congregates. Murmurs build upon murmurs from the bed next ‘door’, building into a heavy cloud of more and more detailed words. The ‘murmuration of medical words’ brings together the visual and the auditory, so that a visual picture can very quickly be made (from the information of another). The patient information, including ‘numbers and percentages’, and the interpretation of that data then exists as an oral presence ‘hang[ing] in the air’.
If we assume that the Russian speaker is the patient in Gleeson’s writing, even their gratitude and response is open for anyone to hear. There is no privacy in what the doctor has to say, and nor is there any for the patient’s response. This is even more significant if we consider the fact that a patient is expected to say very little, ‘Spasibo’ perhaps marks the end of the exchange. What opportunity is there for the patient to question? What opportunity is there to advocate for themselves, maybe argue, plead, confide further private information? Does other noise in the ward help retain a vestige of privacy? While reflecting on his medical student days, and attempting to take a history from an uncooperative epileptic patient, Colin Grant remarks: ‘On the long, high- ceilinged ward, the constant drone of the floor-polishing machine camouflaged conversations. So that even though it was an open ward, with no screens to soften sound, taking a history could be conducted with a degree of confessional privacy’.[3] Grant may well be right, believing he is still able to professionally, correctly, and appropriately take this patient’s history, but this is not from the patient’s viewpoint. How much privacy and protection does the patient actually have? Confessional privacy is not guaranteed: how much does the ward’s ambient noise really prevent private details being heard?
Outside of the curtain, it is impossible not to hear. The murmurs and sounds capture others’ attention, and it is only human to try to understand who the voice belongs to. Whether we want to be or not, we are listeners; we may not be observers of the consultation or of the patient’s body in the moment, but the information that flows through the air lingers and lands on our nearby ears.
What is heard cannot be unheard.
References
- S. Gleeson, Constellations, (Picador, 2019), p. 110-11.
- T. Rice, Hearing the Hospital: Sound, Listening, Knowledge and Experience (Sean Kingston Press, 2013) p. 45.
- C. Grant, A Smell of Burning (Vintage, 2016), p. 3.
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