Losing the Ground
I'm section hiking the Appalachian Trail, almost 500 miles completed thus far, working through some seriously mountainous terrain, and my shins have been paying for it. Shin splints, mostly, the kind that make you rethink every step. Someone recommended Hoka trail shoes, which carry some of the thickest cushioning on the market. I bought a pair and started walking.
The relief was real. My shins stopped screaming. But something else happened that I didn't expect. I couldn't feel the ground anymore. It was like walking on pillows. The trail was still there, roots, rocks, the actual terrain I was supposed to be reading with my feet, but I'd lost contact with it. I felt disconnected. The word that kept coming to mind was artificial.
I started noticing how many other barriers like this exist in my life. Air conditioning between me and the heat. Air filters between me and the air itself. Sunglasses between me and the sun. Noise-canceling headphones between me and environmental sound. Each one is reasonable on its own. But I don't think I'd fully noticed just how much of my daily life is built this way, one artificial or manufactured buffer stacked on another, until the Hokas made it impossible to ignore.
What I noticed
I didn't come away from any of this with a clean conclusion. Mostly I noticed how much separation there is, and how much of it is optional, chosen. Most of these barriers start as something useful, a way to solve a real problem, cushion for shins, cool air on a hot day. But somewhere along the way the useful thing becomes a substitute for direct contact, and I stop noticing the substitution has happened at all.
The reflection I keep coming back to is simpler than any of that: being comfortable with the uncomfortable is a great teacher. Often, when I put a barrier up, artificial or otherwise, I lose a chance to actually feel something and connect with it, whether that's my own emotions or someone else's suffering. The barrier doesn't just keep out the hard thing. It keeps out whatever might have come from staying with it a little longer.
I ended up returning the Hokas for a pair with less cushion. I still have some support underfoot, enough that my shins aren't screaming, but I can feel the ground again. That felt like the right trade. I'm trying to carry the same instinct into the rest of it, noticing when I've reached for the cushion out of habit rather than need, and what I might be giving up each time I do.
The question for product design
I spent most of my working life building and commercializing products for people managing disease. So the question I can't put down is what this means for that work.
When we design a healthcare product, what barriers do we place between ourselves and the discomfort of the people we're designing for? A persona instead of a person. A dashboard instead of a bedside. Aggregated data instead of one patient's specific, unglamorous struggle to take a pill on schedule or get through a clinic visit. Journey maps built from research sessions that last forty-five minutes, scheduled, incentivized, and then over, standing in for lives that don't have an end time.
None of that is wrong exactly. You can't run a company by sitting with every patient individually. But personas, dashboards, and aggregated data are still artificial, the same kind of manufactured buffer as the Hokas, standing between us and what's actually happening to the people we're building for.
I'm not sure the answer is to strip all of that away. Personas, dashboards, aggregated data, they exist for real reasons. But I think we owe it to the people we're designing for to examine these barriers and stay mindful of them, to know what's artificial in how we're seeing them, and to be honest about what we risk losing as we choose scale over proximity.