coma. Not enough insulin, and they have high blood sugar, which causes long-term complications, including loss of limbs, eyesight, and failing organs.
All of this is a lot to learn and a lot to take in as a parent of a diabetic child. For the child, it’s a whole new way of living that—until a cure is found—overshadows everything else. My wife and I were fortunate in that our hospital had a superb training program to prepare parents and children for this new life, this “new normal” that you quickly adjust to.
During the three-day “retraining” process, the hospital gave us a lot of useful information. They helped us process what to expect. And they gave us plenty of paperwork.
Among the many forms we were given, mostly of a legal/compliance nature, special attention was given to the form in Figure 1.1.
This is the sheet that you put on your refrigerator, the “one-pager” that is meant to organize everything you’ll do in a day. It is the checklist of all the things that you need to know: When to give your child insulin. When to test blood sugar levels. How many carbs they can eat. How many units of insulin to give. All the information you need to know is in this form.
This form is also broken.
FIGURE 1.1 The diabetes management aid provided to families as a daily checklist for monitoring blood sugar, tracking carbohydrates, injecting insulin, and so forth.
This form is so very confusing that nurses routinely spend 30 minutes explaining it. Moreover, a couple areas on this form are outright dangerous—if misunderstood, you could harm your child by giving them too much insulin.
After the nurse left the room, my wife looked at me and said, “You’ve got to fix this.” What you see in Figure 1.2 is my makeover of this chart.
As dramatically different as this version is, I want to highlight something: I did not add any information, nor did I remove any information. All that has changed is how the information is presented.
My goals were simple:
1. I wanted to create something that my son—at only four years of age—could look at and get a sense of what he was supposed to do. I wanted him to manage this disease from an early age. I needed him to understand what was expected of him.
FIGURE 1.2 This version of the diabetes chart has the same information as the one provided by the hospital. All that has changed is the visual design.
2. I wanted to give us, as parents, a sense of control. My wife and I needed to create something like this. Of course, we needed to understand what was expected of us. But on a deeper level, we needed something we could control. As parents, you’ve done everything right, fed your child the right foods, avoided the things that might harm a child. And yet, something like this happens, for no explicable reason. We felt powerless. Creating this chart was one way for us to assert some level of control over a small piece of the diagnosis.
Now, what about the after version? From a graphic design perspective, there is plenty to critique. The icons are inconsistent. There are some padding and alignment imperfections. Color schemes are meh. I could have fixed this with more time. But winning a graphic design award was not my goal. My goal was to make the information understandable and fixating on small tweaks wouldn’t make it much more understandable. This kind of transformation is largely functional, not aesthetic. Moreover, it’s something we can all do, or should be able to do, by the time you’re finished with this book.
If you can organize a closet or sort spices in a kitchen cabinet, you can do what I’ve done here. At the core, all I did was identify and align “like” information. If you look closely at the before version, you can see three kinds of activities listed (finger pokes, insulin shots, and eating), as well as the times for each; this information was—in the before version—listed, but not shown. By introducing a column for each of the three types of activities, then mapping those columns against the time of day, resulting in a grid layout, we could see more clearly when to do which activity. (This also allowed us to be explicit about when we should not do an activity as well, as indicated by the × shape.) This chart was largely about using space to hold meaning, something that we’ll explore in detail.
Beyond this sorting and alignment exercise, I added images to reinforce the literal things being referenced with words: the column headers had corresponding images (finger for finger pokes, needle for taking shots, a food tray for eating). Where finger pokes were involved, I grabbed a “drop of blood” icon (courtesy of a Google image search). And when it was time to give my son a shot, I reinforced the language of which type of insulin by adding illustrations of “H” or “N” vials of insulin. Where something was optional (“only if needed”), I used opacity to fade that back into the background, a type of visual encoding that we’ll also discuss.
Understanding Is Created
It is a truism and a time-worn cliché that we have more information—and more access to information—than at any other point in history. Yet all this information doesn’t get us especially far if we can’t make sense of it. At the same time, we tend to assume that information should come in an understandable shape. When it does not—when we are given information but not understanding—we are likely to blame the information-industrial complex for failing us. This is why the diabetes chart example is so irksome. Medical professionals provided accurate and reliable information in a critical situation, yet also left my wife and me feeling uncertain and powerless and fearful of doing harm to our child. While the hospital’s training program was superb, my family needed more from that chart, a great deal more, given the pivotal role it would play in our lives.
But consider this story from another angle. While we should have been given a more understandable chart, should we also expect all information to be this way? Should every bit of information that comes our way be instantly and immediately understandable? Is it reasonable, or even possible, to be given understanding anytime we are given information? There are many situations, such as health and public safety, when information should be unambiguous. This has led to standardizing the meaning of everything from traffic lights to symbols on radioactive material. But even when the information before us is clear and comprehensible, the path to understanding may still require us to engage with it. Quite often, we need to create understanding.
Suppose that you wanted to knit a pair of socks, and we gave you the best book ever written on the subject, the best instructional videos ever produced, and a few hours with a world-class knitting instructor. Furthermore, let’s consider what would happen if you divided the process into two stages. In the first stage, you would absorb the information from these three world-class sources—reading, watching, listening closely, and taking it all in. Once you’d gone through and studied all the information, then, and only then, would you move to the second stage: sitting down and starting to knit. Such an approach seems silly and doomed, no matter how clear the information is or how wonderful the instruction. You would still need to act. You would need to pick up the needles and start knitting, ask questions, review the examples, make mistakes, and keep going. This would be true even for experienced knitters. The understanding comes through doing, not just taking in information.
Even the revised diabetes chart, despite the improvements,
