Looking inward, seeing out
This is not a
particularly large cafeteria, as hospital cafeterias go. It has five booths,
seven tables around the perimeter and eight tables in the center in the main
area and six tables just outside the doors. It holds just a few more than 100
people when filled to capacity. It is attractive and well maintained. The paint
is new and the color is pleasing. The tabletops show no scars and the bases are
upright and stable- no wads of paper wedged beneath a leg for stability. The
chairs are plentiful, in good repair and there are no mismatched pieces. The
tile floor is a few steps up from the usual and expected linoleum, with
nature’s patterns and textures and real grout. It, and all the other reflective
surfaces, shines in the sun. Shiny and reflective mean clean in cafeteria
world. Time has not had much opportunity to cause damage here and what wear and
tear there has been, maintenance has minimized.
This cafeteria is small but choice in a way other
hospital cafeterias cannot begin to match. Most any restaurant would be hard
pressed to offer what the cafeteria does. It has an incomparable view. And
while it is new and upscale and well cared for, shiny with cleanliness and easy
on the eye, it is the view that makes it special. Novak and Richardson point out that “ninety-five
percent of all individuals who are asked how to alleviate a stressful situation
respond that they are most comforted and soothed by being outdoors” in their
discussion on design for healthcare environments (Novak & Richardson, 2013) . The “25 Most
Beautiful Hospitals in the World” (Healthcare Business & Technology, 2012) lists hospitals in
Vienna, Zurich, London and Bangkok but the photographs show buildings, not the
settings and there are no views. Providence
Note.
From “The 25 Most Beautiful Hospitals in the World” by Healthcare Business
& Technology, 2012, retrieved from http://www.healthcarebusinesstech.com/the-25-most-beautiful-hospital-designs-in-the-world/
Alaska Medical Center made the list, and
the picture shows the campus sitting in the Anchorage bowl, but any view from
the hospital belongs only to a special few. The single listed hospital with a
real view is The Matilda Hospital in Hong Kong, but the hospital website does
not indicate if the hospital even has a cafeteria. This cafeteria has a real view and everyone
can have it. One wall is all windows and
tables sit all along it. It is easy here to be a passive observer, absorbing
the activity and interpreting the behaviors to form conclusions (Kumar, 2010) .
Figure
1. View from cafeteria window wall
Passing by several times,
and not always at the same times, during the day, it is easy to observe that there
are people using at least two or three tables in the main section from opening
until closing time. It is a gathering spot for more than just meal service;
there are often couples or larger groups sitting and talking without any food
items before them. The cafeteria offers complementary coffee and tea and some
people sit and sip without ever eating. A few sit alone, pensive and facing
inward. They are not admiring the view. They seem focused on something that
others do not see and would not wish to; a vision that is grim, judging by
their appearance. Most sit in company
and some of these duos do not look to the view either. They sit in the center
of the room and look in to the cafeteria. While they may speak to one another,
their eye contact is limited, their speech is hesitant and their movements are conscribed. They are drawn in on themselves and seem uninterested in the beauty
around them. Most people, two and three
together, prefer the tables that line the windows and these fill first and are
slow to empty. At these tables, the light comes in and people squint to eat but
no-one shifts position. They sit there for the sun and the view and they are
enjoying both.
Although it is a hospital cafeteria, the
majority of people sitting are in civilian attire. There are plenty of people
in uniform, but they are in the food line and at the salad bar. If they sit,
they sit in larger groups and they sit at the tables outside of the main area.
The arrangement of these tables, the large numbers of people sitting close
around a table designed for a smaller crowd, the noisy chatter and laughter, heads
bent over and pressed together, give this spot a more than passing resemblance
to a high school cafeteria. The view and the décor make it an upscale high
school, but it still resembles high school in miniature. These groups flock in
and launch out en mass, like a covey of birds that swoops in, jousts for
position on the telephone line and then departs all at once, all together. Lunch break is short and a good portion of it
is spent waiting in line; the line is noisy with talk and the conversation is
carried to the table where it continues without pause until the break is over.
Eyes go regularly to the view but most attention is paid to the company and the
talk. Heads are tilted in towards the speakers; there are smiles and grimaces on
more than one face, even those whose eyes are on the view. There are few older
adults in these groups. They appear healthy and vital, their energy is high and
they are bright and attractive in their interest in each other and their
surroundings. It would be nice to sit with such people and enjoy their company
along with the view.
The loners, the one-at-a-table-for-four,
come in two types. Those that are there for meetings- the outside providers,
salesman and product reps, job seekers- they sit with coffee and their papers
on the table. Their briefcase, when they have one, is open on a chair next to
them and their active project/quote/resume is stared at, poked with a pencil
tip, and mostly shifted around the table surface like the answer will transfer
from the wood laminate of the table top to the paper if they only rub hard
enough. They have their iPad and their smart phone to occupy them and they
have, in general, not much appreciation for the view. They are mostly killing
time until the appointment hour. They pay more attention to the clock and their
watch than to the scenery outdoors. They are young to middle aged and uniformly well dressed. The others, who generally appear less put together than the
appointment waiters, are probably family members of patients. The better
prepared among them also have their iPad and their smart phone since they too
are bound to spend some time waiting. A rare few look out at the view but more
look at their source of distraction- their phone, their tablet or their own
internal landscape. The items they use for distraction work intermittently.
They are busy and focused for a short time, then they look up and look around,
their faces lose their intensity, become soft and sad. The ages for these
people vary but lean towards late middle age to older adult. An older woman,
perhaps early 60’s, has a paperback book. It is from the Outlander series. This
seems a particularly appropriate choice for someone who appears out of their
element. She has reading glasses that she puts on and takes off repeatedly to
wipe. She reads and puts the book down, picks up her cup and sips, picks the
book back up, takes off her glasses and wipes, with the tips of her fingers she
pushes the book a few inches from her and pulls it back, picks it back up and
reads again. She rarely turns the page. She is not quite aware of the cafeteria
but neither is she in the book.
There are family groups
with children. These people are attentive to each other and their surroundings;
they chat easily and touch each other frequently. For a few, at odd moments,
their gaze becomes unfocused and they look lost and confused, some look pained.
It passes quickly and their attention returns to their companions. It is
usually the older members of the group, men and women past middle age and approaching
or at old age, that seem to be taken away from the cafeteria, just for a
minute, to another place that only they see. Some appear anxious and their
movements are awkward and pressured. The stress is almost palpable at the
tables where these people sit; it ripples the air like heat waves. The children
in the group are bright and loud but just a little shriller than they should
be. Their stridency and hectic motion makes the older adults wince and flinch
back.
With a longer period of
time to spend in the cafeteria, it would be easier to visualize patterns. Where
people sit when tables are empty on the periphery and along the window is
different at different times of day and also depends on the group and their
purpose for being there. How strangers interact in this place would be a study undertaken
over a longer time period; it is beautiful here but the beauty is not
appreciated by everyone. Some have sour expressions, some look angry. Do they
speak to others and who speaks to them? Some family members who come here
appear more at ease. They may remain for hours and days. What helps them to
achieve a degree of comfort so far removed from home? A few have set up an
environment of their own; perhaps they have experience of hospitals and
waiting. It would be interesting and useful to hear how they are able to adapt
when others do not. The qualitative researcher applies inductive reasoning to
achieve understanding and assign meaning (Grove, Burns, & Gray, 2010) . Time spent observing
the actions of discrete individuals and of connected groups and focusing
attention on how they interact with others and the environment is the basis of
inductive reasoning.
I love the cafeteria and
bring people there for meetings, so we can speak while sitting by the windows
and drinking coffee. It is like the exclusive resort that only holds the
smallest number of guests. A little jewel in paradise, it is a destination and
a treat, only this one some of us can enjoy every day. Others avoid it and eat
in an oversized closet so they can enjoy only the company of themselves or
their peers. They do not wish to interact with others or with the view. While
watching how others did/not interact with the view, I was oblivious to the
environment. I stood at the coffee bar or sat outside the doors, sometimes on a
bench across from the cafeteria with my back to the view. I was one of the
“one-at-a-table-for-four” people, moving my cup to mouth and my phone around
the table top. It was shameful to waste the opportunity to make memories from
the mountains and light and all the things that are green, but I was there for
a purpose and not to just enjoy the sun and the view. It is interesting to
consider what captures and holds our attention and how this changes depending
on events and surroundings or time of day or year. I tried to watch without listening and
interpret what I saw just from expressions and movements. Without the words to
explain what I was seeing, faces and body language became the medium of speech.
I felt some people were yelling what they thought while others were better at
masking their concerns or their pleasure. I did not realize that overhearing
only a word or two or even the tone of a murmured conversation goes a long way
to telling me what is happening the next table over; making a conscious effort
to ignore those cues meant paying attention in a very different way. I found
myself thinking about the experience of the passage of time. The cafeteria and
how it has been maintained against time and wear. How people are impacted by
the passage of time- what aging means, how lives change, how older adults are
at time’s mercy- and how we waste time, mark time, bask in the sun and the time
of the season. I came through the cafeteria at a few different times and the
population was different. I did not sit down to observe thinking I would become
a cafeteria philosopher. Reflexivity, my familiarity, comfort and involvement
with this environment, made observations easier for me to interpret but also
created the opportunity to mistakenly attribute what I observed to what I
expected, given the location and the people found here (Reeves, Kuper, & Hodge, 2008) .
References
Grove, S., Burns, N., & Gray, J. (2010). The
practice of nursing research (7th ed.). St. Louis, MO: Elsevier.
Healthcare Business & Technology. (2012, March
15). 25 most beautiful hospitals in the world. Retrieved from Healthcare
Business & Technology: http://www.healthcarebusinesstech.com/the-25-most-beautiful-hospital-designs-in-the-world/
Kumar, R. (2010). Research methodology: A
step-by-step guide for beginners. Thousand Oaks, CA: Sage.
Reeves, S., Kuper, A., & Hodge, B. (2008).
Qualitative research methodologies: Ethnography. BMJ August, 337-339.
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