It was a terrifying sight: a clutter of cables, tubes and pipes was hanging down from the ceiling and gave the scenery the impression of a torture chamber, just like you know from these old b&w horror movies - hello from Dr. Frankenstein!

Somehow it seemed that the grim atmosphere had no influence on the personnel working there: they were completely focussed on preparing patient for an intervention. As I had still to learn: with 'the patient' they were referring to the medical case, and not necessarily to the person himself - a subtle but crucial difference.

The torture chamber actually was a surgery room, a cath lab to be precise, where the patients, through the aid of a catheter and a stent, had their coronary artery widened-up, so that they could climb-up the stairs again. For the cardiologist this is a routine job, for the likes of us it's a true torture.

My colleague and me were allowed to observe the interventions, because we had to design the successor of the medical system they used. That was a kind of x-ray cannon, which was wrapped around the patients in order to shoot 'minimal' doses of radiation through their bodies (which as such also did not support in reducing the intimidating character of the whole scenario). The cardiologists (often sturdy guys, who are well in shape from dragging around a leaded vest the whole day) are not really in the position to ease the patient, since they have to fully concentrate on the monitors hanging from the ceiling - on these all the important stuff is displayed and one can control how the catheter is making it's way towards the stenosis (that narrowing-bit causing all the trouble). 

That's why in designing such devices and systems the focus is mainly on improving the ergonomic performance by placing and shaping all control devices in such a way that the cardiologist can operate the thing blind-folded - which actually he does: he's only looking at the monitors most of the time.

Now and then the cardiologists were talking to their patients, mostly without looking at them. "Hold your breath" they would say, or "keep still now" a bit louder and forceful, because the success and the duration of the intervention is highly dependent on the patient's patience - they are not anesthetized and therefore 'alife'.

True, this doesn't sound like a 'great' design job to do, you can't create flashy renderings for your portfolio - at least that's what we thought in the beginning. But with both my colleague and me the interest grew in course of our observation and we clearly noticed that the patient seemed way more important than we initially thought: if they could remain calm, it was all over quite quickly. If they were impatient and not clam, also the intervention took longer, which was making things even worse. So we started to focus on the patient and not on the system and the cardiologists - we knew we had to improve the design also for them!

As soon as all interventions were done and the room could be used by us, the designers and the engineers, I climbed on the table and took the patient's view-point. As I was lying on the table and taking some photos, the engineers were asking me what the heck I was doing - also the cardiologist was shaking his head: "these designers", I'd catch up somebody mumbling…

After arriving back into the studio we immediately started to design the system in such a way that it would radiate a less intimidating impression. Also we created some focal points for the patients, so that they would have 'visual' distraction or stimulation. To active this my colleague was looking for new manufacturing techniques while I was doing the 'renderings', which turned out to much nicer than we were anticipating.

The new design was really great, to our opinion, but the engineers and product managers didn't really share our enthusiasm, yet. Their initial reply was like what we were thinking of, to use such complicated product parts, which would increase the moulding costs and which were planned to be put at the top of the product. "The cardiologists never look in that direction, and it's also never getting 'bloody' up there!" - was was the reply by one the colleagues from the business.  

Nevertheless, we were convicted - and one after the other we could convince our colleagues in the business. At last the product was excecuted the way we had proposed and luckily also the business case proved to be positive. Even more positive was the fact that the product won all important design awards, and with that the medical systems business was put in the limelights - it grew pride and enthusiasm, but that alone didn't make the business results, yet…

When also those targets were outperformed by far, the managers started to look for the reason behind the commercial success - could it be the design? 

One reason was given soon after by a cardiologist from Florida, who reported that he had no clue what had changed over the predecessor, but "with the new system I can have at average two more interventions a day! Somehow the patients are more at ease… So I ordered another two labs" he closed of his praise. 

Sometimes money doesn't lie on the ground, but is stuck to the ceiling - you just have to re-focus once a while: have a design focus!