Hello! Welcome back to another Review. We’re slowly getting through January - well done!

This week for me

I had my first eye test in 5 years. I’ve never seen an optometrist get angry before. I guess there’s a first for everything. My excuse of ‘there was a pandemic, then we had a baby’ just didn’t wash with her.

However, I’m grateful for her angry. She made me take it seriously. However, it is a bit uncomfortable to meet a health professional who has the time to care, mostly because you are paying a premium for their time and expertise. However, I really respected the fact that she gave me a level of care that was beyond what she was charging me for. She did it because she cared about my eyes and wanted to make sure they were OK.

I wish for a world where every person who cares for us, provides tailored treatments and supports us to help ourselves in our health and wellbeing is remunerated and in turn cared for themselves, as much as my optometrist is.

Another world is possible!

Right. Onto the links!

Research on the edges

🥽 Inside the metaverse meetups that let people share on death, grief, and pain

Waiyaki says he didn’t allow himself to process his sister’s death until he did it through VR. “Men, in my society, can’t be seen breaking down,” he explains. “At Death Q&A, I was able to put the baggage down. I was able to mourn and cry the tears I hadn’t cried before. It hurt to, but I could feel a wound heal as I did.

Look, I’ll be honest: A big part of me doesn’t want the ‘metaverse’ to succeed. I think we have enough separation and isolation through our phones to make things as bad as they are. However, this is almost enough to change my mind. I love how this emerging technology is finding real value and use for groups of people. This is also true for other therapeutic modalities.

📖 Understanding the history of death is key to shaping the future of how we die

The partial exclusion of children from funerals points to a change in the culturally accepted expressions of grief. For most of history, mourning was a public experience – people would change their appearance or their clothing to symbolise their loss, and the dead would be collectively remembered at regular intervals. But this changed during the twentieth century so that now there is an expectation that grief can be managed privately or with the help of a professional.

Rather than there being an ongoing remembrance of the deceased, prolonged grief may be pathologised (the American Psychiatric Association, for example, recommends individuals see a grief counsellor if they are still mourning after 6 weeks).

A good brief overview of how we got to our current cultural attitude towards death (in a Western European/Anglosphere way at least). There has been a lot of discourse about how death should have it own ‘sex education’ in schools. But this has historically been used to reduce unwanted teenage pregnancy and avoidable diseases, so what is the metric here that we would be using?

🏥. Why More Money Alone Is Not the Answer to Britain’s NHS Crisis

The NHS has been the be-all and end-all of our health universe for the past 75 years despite the Beveridge Report asserting the importance of prevention and the role of family and community in creating health. Now is the time to put “health” back into the National Health Service and allocate a greater proportion of health expenditure towards health.

The headline has been in my head since I first read Humanising Healthcare around 2015: more money won’t solve the problems we have. So its interesting to continue to see this through the political discourse. It feels almost inevitable that Labour will win the next general election, so seeing what is coming out about health can give you an idea of the direction of travel for the NHS (hint: I don’t think it’s as simple as saying we are worried about ‘more privatisation’).

💀 Death and the bogus contract between doctors and patients

The bogus contract where patients believe that doctors can do more than they can and doctors go along with the belief is highly—I might even say fatally—attractive to both patients and doctors. But ultimately it causes excess suffering for patients and infantilises them, while doctors are left with the discomfort of being evasive, dishonest, or cowardly.

Piercing exposure to the culture of medicine from the great Richard Smith, who co-chaired the Lancet Commission on the Value of Death (which I think is the most important piece of research on death and dying thats been published recently).

📖 What I’m reading

I’m starting a new project this year around mental health at end of life. It’s building on some work we did a few years ago that we’re finally coming back around to. Back then we identified that if we were to make any serious impact on improving people’s mental health at end of life, we would have to stop taking a siloed, individualistic approach to the problem (and recognise that often there is not a clear cut ‘solution’ to create). All this led me down the path of identifying that a whole systems approach may be most useful here. With that in mind, I’ve kicked off the year with a fantastic book by Peter Jones and Kristel Van Ael that came out late last year. It’s early days for me on this project, but Peter and Kristel have handily compiled practical tools for designers to use when they are working with systemic design practices.

Design problems have grown in complexity beyond the capabilities of the creative design disciplines, and system problems have grown beyond the linear problem-solving of engineering, management, and policy. For the complex challenges of the 21st century, we require multiple disciplines, collaborating in coordinated learning teams toward a deeper understanding of contexts and social systems. Often, complex challenges will come framed by the sponsor in fuzzy, abstract terms, such as 'a better healthcare system for all; reducing the threat of cyberattacks, or climate resilience. These are challenges that demand a deep rethinking of policy or programme planning so that meaningful interventions can be discovered through re-framing. New frames are co-created together, to expand the problem context to include expertise of all kinds, including the lived 'expert experience' of the victims of prior bad decisions, so we might collaborate wisely on systemic solutions and agree on action planning.

Thank you for reading so far. If you’ve enjoy this Substack and you think someone else will, please share it!

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🎧 Listen

Playing Piano For Dad is in my top 5 albums of the last 10 years. I cycle back to it once a year and have it on repeat for ages. It’s a very understated jazz piano album by a mysterious pianist (treading closely into One Hit Wonder territory).

‘playing piano for dad’ was initially conceived as a Christmas gift to the composer’s father. Intimately recorded, ‘playing piano for dad’ is a heartbreakingly gorgeous & sincere work of eleven vignettes which capture even the most nuanced sounds of the recording session - the composer’s breath, the shifting sounds of the piano pedals, the ambient noise and conversation within the studio.

I first heard it before I took my wife to New York for a birthday weekend (ah pre-pandemic, pre-baby life, I miss thee!) and since then it has reminded me of a very particular feeling. The whole album to me sounds like the first night of a guest pianist at the King Cole Bar at the St Regis. He’s talking to himself, steadying himself, bumming a few notes, but playing with real juice that it doesn’t matter. Heartfelt.

It’s a perfect album for dark, cosy evenings. Wrong I is my personal favourite.

🤔 Last thought

Jessica 🤭 @jessicamalonso

“So many people associate tightness in the throat, in the chest, in the eyes, in the forehead, with grief, but that’s actually the brakes on grief, trying to stop it. When we get out of the way, allow it to move through, allow it to take over, it actually is quite expansive.”

Don’t hold back from the emotions you need to feel.

See you next time. Thanks for reading ☺️

“We are here to help each other get through this thing, whatever it is.”

Notes from the Edge by Ivor Williams

Weekly Review Issue no. 8