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Playing in public: Johann Sebastian Joust

The rise of digital folk games, which are designed to break social taboos, to get strangers talking and interacting and to make public spaces feel more friendly.

We are circling each other, me and the tall, bearded man. As the music speedsup, he lunges, aiming for the microphone-shaped object in my hand. I spin away – too fast, as it turns out. The light bulb on top of the object turns from purple to red and it’s game over for me.

I’m nearly 29 years old, so I haven’t played anything approaching “tag” in public for two decades – but here I am, at the Hide and Seek Weekender at the Southbank Centre in London, making a fool of myself in front of strangers. The game we’re playing is called Johann Sebastian Joust and it’s an experiment by the Danish developers Die Gute Fabrik.

Two to seven players hold motion-sensitive PlayStation controllers –which look like microphones with an illuminated doorknob on top – and listen to the Brandenburg Concertos. When the music starts, at a slow tempo, the controllers are extremely sensitive; as it speeds up, you can move more quickly. If you bust the limit –by lunging wildly at another player or having your controller jostled – the illuminated knob changes colour and you’re out.

Although Johann Sebastian Joust is technically a video game, it requires no screen and no special knowledge. It is part of a growing genre called “digital folk games” that attempts to capture the experience of playground classics such as tag or grandmother’s footsteps for adults.

The creator of Joust is Douglas Wilson, who is studying for a doctorate in interaction design and design theory at Copenhagen University. His guiding principle was simple: “Moving in slow motion is rad and we should do a game about that,” he told the online magazine Verge.

Joustisn’t available commercially but you can play it at games festivals and expos around Europe. The Verge writer Griffin McElroy rigged up a laptop with an early version of it in his flat (at one point, he hid in his shower, hoping his four opponents would “knock themselves out”) and also played outside at night, making the glowing tops of the controllers even more important.

After playing Joust (and losing every single game through overconfidence), I moved on to Romeoke – “avant-garde karaoke meets Asteroids” – in which you control the movement of balloons on screen with your voice. Yes, you feel stupid going “oooOOO” in public: that’s the point. Digital folk games are designed to break social taboos, to get strangers talking and interacting and to make public spaces feel more friendly. There’s a video on Die Gute Fabrik’s website of Joust being played on the streets of Copenhagen. Curious crowds soon gather around the players; before long, they are joining in.

This all might sound like an excuse for a bunch of adults to lark about but the gamers are being supported by academic research. “Play” is being recognised as a valuable antidote to more intense jobs and more atomised urban lives. As Brian Sutton-Smith, the former dean of play studies at the University of Pennsylvania, once put it: “The opposite of play isn’t work. It’s depression.”

Helen Lewis is deputy editor of the New Statesman. She has presented BBC Radio 4’s Week in Westminster and is a regular panellist on BBC1’s Sunday Politics.

This article first appeared in the 24 September 2012 issue of the New Statesman, Lib Dem special

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Want to know how you really behave as a doctor? Watch yourself on video

There is nothing quite like watching oneself at work to spur development – and videos can help us understand patients, too.

One of the most useful tools I have as a GP trainer is my video camera. Periodically, and always with patients’ permission, I place it in the corner of my registrar’s room. We then look through their consultations together during a tutorial.

There is nothing quite like watching oneself at work to spur development. One of my trainees – a lovely guy called Nick – was appalled to find that he wheeled his chair closer and closer to the patient as he narrowed down the diagnosis with a series of questions. It was entirely unconscious, but somewhat intimidating, and he never repeated it once he’d seen the recording. Whether it’s spending half the consultation staring at the computer screen, or slipping into baffling technospeak, or parroting “OK” after every comment a patient makes, we all have unhelpful mannerisms of which we are blithely unaware.

Videos are a great way of understanding how patients communicate, too. Another registrar, Anthony, had spent several years as a rheumatologist before switching to general practice, so when consulted by Yvette he felt on familiar ground. She began by saying she thought she had carpal tunnel syndrome. Anthony confirmed the diagnosis with some clinical tests, then went on to establish the impact it was having on Yvette’s life. Her sleep was disturbed every night, and she was no longer able to pick up and carry her young children. Her desperation for a swift cure came across loud and clear.

The consultation then ran into difficulty. There are three things that can help CTS: wrist splints, steroid injections and surgery to release the nerve. Splints are usually the preferred first option because they carry no risk of complications, and are inexpensive to the NHS. We watched as Anthony tried to explain this. Yvette kept raising objections, and even though Anthony did his best to address her concerns, it was clear she remained unconvinced.

The problem for Anthony, as for many doctors, is that much medical training still reflects an era when patients relied heavily on professionals for health information. Today, most will have consulted with Dr Google before presenting to their GP. Sometimes this will have stoked unfounded fears – pretty much any symptom just might be an indication of cancer – and our task then is to put things in proper context. But frequently, as with Yvette, patients have not only worked out what is wrong, they also have firm ideas what to do about it.

We played the video through again, and I highlighted the numerous subtle cues that Yvette had offered. Like many patients, she was reticent about stating outright what she wanted, but the information was there in what she did and didn’t say, and in how she responded to Anthony’s suggestions. By the time we’d finished analysing their exchanges, Anthony could see that Yvette had already decided against splints as being too cumbersome and taking too long to work. For her, a steroid injection was the quickest and surest way to obtain relief.

Competing considerations must be weighed in any “shared” decision between a doctor and patient. Autonomy – the ability for a patient to determine their own care – is of prime importance, but it isn’t unrestricted. The balance between doing good and doing harm, of which doctors sometimes have a far clearer appreciation, has to be factored in. Then there are questions of equity and fairness: within a finite NHS budget, doctors have a duty to prioritise the most cost-effective treatments. For the NHS and for Yvette, going straight for surgery wouldn’t have been right – nor did she want it – but a steroid injection is both low-cost and low-risk, and Anthony could see he’d missed the chance to maximise her autonomy.

The lessons he learned from the video had a powerful impact on him, and from that day on he became much more adept at achieving truly shared decisions with his patients.

This article first appeared in the 01 October 2015 issue of the New Statesman, The Tory tide