A Conversation with Tina and Miya
post-Nordes Conference on Care
– By Emily Franklin
I met Miya and Tina for the first time as they were preparing their Journey Mapping workshop for the 8th biannual Nordic Design Research Society (Nordes) conference at this beginning of this month, prior to starting my tenure as their summer intern. They invited me to roleplay the workshop (sort of like a dry run) to work out any last kinks.
This year Nordes centered around care, they explained. Miya and Tina were to present a workshop that draws on innovative design research methods—Journey Mapping probes that encourage self-reflection and storytelling, uncover unmet needs, emotions, delights, and obstacles that can be challenging to capture in traditional research. The Journey Map encourages participants to think of care experiences, not just treatment experiences, to inspire a more holistic image of health. Their workshop expressed the value of narrative tools in healthcare through three activities: First, participants visualized their own “Story of Health” using the Journey Mapping cultural probe. Second, maps were anonymously exchanged, reviewed, and embodied by participants to build empathy. Third, a co-design session analyzed the journey map outputs with a discussion around learnings and value of Stories of Health for stakeholders and communities.
After being briefed about Diagram’s extensive experience with narratives in healthcare and the details of the workshop, much like the participants would be the next week in Helsinki, I filled out my own Journey Map. I, along with another volunteer, was prompted to think of my own health journey, using stickers depicting familiar objects, like celebratory champagne bottle or a sign indicating a crossroads, as metaphors to enrich our narratives. I was surprised by how evocative my story became, at how, through interacting with the materials, I was able to illustrate an emotional narrative arc. But I was most surprised about how an image—a raft specifically—suddenly became necessary in that moment to my ability to tell my story.
Now that they’re back from Nordes and I’m officially in the office, I was excited to sit down with them to hear how actual workshop participants reacted to the Journey Map, and Miya and Tina’s take on the conference.
Emily: You emphasize storytelling throughout the Journey Mapping process, and you offer that patients should be able to view themselves as the protagonists in their health. Can you explain a little bit about why reframing experiences through narrative language may ultimately help patients? And how does storytelling look across different cultures that might use this tool?
Miya: We had a very diverse audience. There were Nordic people, Americans, a Japanese woman, a guy from South America, a woman from Israel, and through our activities around building a narrative, embodying narratives—which was probably one of the more interesting parts of the workshop where people had to tell their story to someone else and then tell that person's story out loud—and analyzing narratives, we learned about cultural differences in storytelling. One of the participants said, “In my culture, you don't like to share things about your health. It's very uncomfortable.” That was really eye-opening feedback. It told us that, Yes, it does work, but it may not be always comfortable.
Tina: I think that storytelling is undervalued in healthcare. We want to be the authors of our own story—it gives us ownership, it gives us agency, and it empowers us. People who oftentimes are in the midst of struggling with a healthcare challenge, or who have been for quite a long time, are never really offered the opportunity to tell their story or given the skill sets to do so. We’re asking ourselves how we can build capabilities in order to write that story, because ultimately that will lead to better decisions.
Miya: Everybody talks about their health, but then they also talk about other things, like relationships and emotions and daily life, and you realize how intertwined all of that is. In a conversation with a doctor or in a health-related conversation, it's so easy to go to the practical things versus the things that really would help to shape a better experience.
Emily: You've been doing Journey Mapping for a while, but were you surprised by anything coming out of the workshop? Do you have any new insights into Journey Mapping that might influence your process later on?
Miya: The Journey Map has always been done at home and as a single person. It was interesting to see how people told their stories differently as a group. For instance, we asked our participants to draw the line of their journey, and instead of just drawing a single line, one woman created this kind of dense, scribbly line. Looking at that, you might say, Oh, it represents intensity, but she said that she drew the line that way because it was about her and her husband together. It meant it symbolized two people going along the same journey.
Emily: I hear you mention people going on a journey together, which is not talked about in healthcare. It's a very individualistic industry. Also, you talk about empathy and narrative, things that are often excluded from healthcare conversations. So, I’m curious about why conferences like Nordes, that value the care part of healthcare, are important right now.
Miya: Nordes was looking at care in many different contexts—social, political, academic, health. The idea of what does care mean is not fully defined. It's nice to have the opportunity to look at care as something that is not just a thing, but also a verb. One of my favorite quotes from Victor Montori from the Patient Revolution is, “Language in industrialized healthcare has made us say things like, ‘We deliver care’ or ‘We provide care,’” and his point is that care is already a verb.
Tina: It's always refreshing to hear about how people manage health care in other countries, because the US can get so insular about our system and our process. We want to broaden our definition of care and try to garner some inspiration from other sources, and not forget that there are other ways to deliver care, and to care for people or communities or society.
Emily: Do you have a favorite image from the Journey Mapping probe? And if so, what is it?
Tina: Right off the bat, there was a lot of dialogue around the cave image—it was a dark cave and I remember people mentioning it and using it a lot. Also the egg!
Miya: Tina is really great at coming up with these images that people connect with. I initially didn’t want the cracked egg because I thought it was too obvious, but our team really fought for it. It’s funny, an egg can say so much—whether it’s cracked, turned on its side, or upright.
Tina: Yeah, the process of developing the Journey Map images can be difficult. You end up scrutinizing the details and it’s frustrating and exhausting. But it is also really rewarding to see people fight for an image, or when some of these images speak to participants.
Emily: Ok, last but not least, you brought back a lot of candy from Helsinki—maybe in honor of National Candy Month, or maybe by coincidence. Which candy do you like best and which will you not be trying again?
Miya: Licorice! The chocolate and licorice—I’ve never had that combo before.
Tina: That was my least favorite. I didn’t even have try it, and I won’t, but I know I wouldn’t like it. I like gummies—anything gummy and anything sour. I like the fake stuff, none of those natural gummies. The texture is weird.
Miya: I’ve never met a candy I didn’t like.