Design Meets Disability

How art can help science augment the body, from hearing aids to prosthetic limbs
by Graham Pullin, from the book Design Meets Disability
July-August 2009
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This is part of a series of stories on design and disability from the July-August 2009 Utne Reader. For more read  Building a Better Arm ,” “ Prosthetic Power ,” “ The Future of Prosthetics ,” and “ The Hype and Hope of Prosthetics .”

The book Design Meets Disability is “about how the worlds of design and disability could inspire each other,” Graham Pullin writes in the introduction. As a medical engineer, Pullin worked with engineers and health care professionals to develop technology to assist disabled people. Later, as a design consultant, he led designers in creating consumer products. “I am struck,” he writes, “by how distant those two worlds still are, yet how much more each could be influenced by the other.” His book is constructed as a series of expositions on words and phrases, laying the groundwork for such an exchange. —The Editors

 

Discretion

The priority for design for disability has traditionally been to enable while attracting as little attention as possible. Medical-looking devices are molded from pink plastic in an attempt to camouflage them against the skin. The approach has been less about projecting a positive image than about trying not to project an image at all.

But is there a danger that this might send out a signal that disability is after all something to be ashamed of? If discretion were to be challenged as a priority, what would take its place?

 

Fashion

Fashion, on the other hand, might be seen as being largely concerned with creating and projecting an image: making wearers look good to others and feel better about themselves.

Eyewear is one market in which fashion and disability overlap. On the rare occasions that the words design and disability are mentioned in the same breath, glasses are often referred to as the exemplar of a product that addresses a disability, yet with little or no social stigma attached. This positive image for disability has been achieved without invisibility.

 

Embracing Fashion

The evolution of glasses from medical appliance to fashion accessory challenges the notion that discretion is always the best policy. Hearing aids, prostheses, and many other products could be inspired by this example. More confident and accomplished design could support more positive images of disability.

Eyewear has come about by adopting not just the language of fashion but also its culture. If medical design wishes to emulate this success, it needs to appreciate that fashion often moves forward through extreme and even controversial work, and to welcome this influence within design for disability. We have to do more to attract fashion designers to collaborate on designs for people with a disability, and bring their perspectives to both the practice and the culture of inclusive design. At times this will expose cultural differences, but these are healthy tensions, well worth embracing and harnessing.

 

Hearwear

You might expect hearing aids to be less challenging than glasses: They don’t obscure the face; there are strong traditions of ear adornment and jewelry in most cultures; and we all reach for earphones and headphones from time to time. But somehow, rather than adopting a diversity of design approaches, the hearing technology industry has remained conservative.

That is why RNID, the British charity for the deaf and hard of hearing, and Blueprint, the architecture and design magazine, launched Hearwear, a project in which leading designers considered hearing aids and hearing technology from a fresh perspective.

Product and furniture designer Ross Lovegrove’s design, The Beauty of Inner Space, mixes organic forms appropriate for a prosthesis with carbon composite and gold. Like jewelry, the design seeks to complement the body rather than attempt to be camouflaged against it. The earphones are recessed to present an ear apparently open to sounds from the outside world, whereas a more convex form might have signaled that the wearer is listening to something else.

The WearHead*Phone is an enormous set of headphones with a military camouflage paint job. Whatever the technical justification for their size, they also represent a supreme gesture of self-confidence—the antithesis of current hearing aids. The camouflage is a reference to street culture, but could also serve as an ironic commentary on the attempted camouflage of pink plastic hearing aids that are conspicuous but pretend to be invisible.

 

Bodywear

In many ways a more challenging area of design for disability is prosthetic limbs. But prosthetic limbs are extensions of the body, not distinct products to be picked up and put down, and as such their design is more sensitive. In some ways it is the body itself that is being redesigned.

Given a challenge of this sensitivity, it is surprising to find that a role for any designer other than design engineers is not even widely acknowledged within prosthetics. A recent contract issued by the U.S. Defense Advanced Research Projects Agency to develop a prosthetic arm made no mention of anything needing to be designed, other than a human form and capabilities being achieved. Correspondingly, the call for proposals demanded an impressive multidisciplinary team of engineers, technologists, and clinicians, but made no mention of designers, let alone sculptors.

 

Legwear

A striking image of a different attitude to prosthetics is that of the athlete, model, and actress Aimee Mullins (see “Prosthetic Power,” p. 54), who is famous in part for her carbon fiber running legs and her ornately carved wooden legs.

Mullins has become an icon of the capable and glamorous disabled person, yet she is clear herself that the best thing she can do for people with disabilities is not to be thought of as a person with a disability.

The unashamed artificiality of Mullins’ prostheses is still controversial. Their abstract elegance challenges the duality that has existed for so long between aesthetics and functionality. Conventional wisdom is that prostheses should be made either for appearance, so-called cosmetic limbs that are an accurate copy of the human body, or for optimized functionality above all other considerations, as are tools. But Mullins’ legs show this to be too simplistic. They have a beauty of their own, not just as objects, but also in relation to her body and posture. Many attributes of even a functional prosthesis affect the image its wearer will project—implications that may not even be treated as conscious design decisions. But they could be, and designers could play a valuable role.

 

Armwear

Prosthetic hands are even more intimate than prosthetic legs, yet again it seems that there are only two common approaches, realism and functionalism. In the realistic approach, materials are chosen for their ability to visually represent human skin: PVC plastic and silicone in shades of pink and brown with molded wrinkles, nails, and sometimes even veins. But the static visual appearance is only one aspect of the aesthetics of any object. Some amputees have spoken of not liking the feel of their hand. They, like anyone, unconsciously cradle one hand in the other, yet the materials are rubbery and clammy. Some amputees even complain that their prosthesis smells unpleasant.

The opposite, functional approach prioritizes how well a prosthesis works over how it looks, and has resulted in split hooks. These may work well as tools, but any hand is more than a tool—it becomes part of the wearer’s body image. Yet the design of split hooks barely acknowledges the wearer’s body or clothing.

Sculptor Jacques Monestier has created a prosthetic hand that represents a provocative alternative to both hands and hooks; it is a design that simultaneously acknowledges its role and also its artificiality. The back of his golden hand is cast in the likeness of a human hand, but from an alloy; the palm is upholstered in soft, luxuriant leather. As Monestier explains, “I wanted to transmute what might be considered disfigurement into something marvelous and exotic. I wanted to create a hand that would no longer cause shame and repulsion. I wanted the amputees themselves to be proud to have a prosthetic hand and pleased to look at it. And for the people around them, I wanted the prosthetic hand to be an object of healthy curiosity, a work of art.”

Monestier was inspired in part by a 16th-century painting of a surgeon fixing an artificial hand to an injured soldier: “It was an armored gauntlet, like a golden hand. A beautiful, vibrant, quasi-mythical object—nothing like those dead, pink, plastic hands that pretend to imitate human flesh.”

 

Excerpted from Design Meets Disability by Graham Pullin, published by the MIT Press. © 2009, Massachusetts Institute of Technology. All rights reserved.


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