Blood Pressure

Jim Colgan
JSK Class of 2020
Published in
8 min readJun 9, 2020

What I learned from an intensive design class leading a team I’d never met with a problem I knew little about.

It felt like I was peering over a steep cliff. I could see how far the drop was, so why would I want to jump?

It was just a class, but as former JSK fellows and students kept telling me, one of the most intense ones you can do at Stanford.

It’s called d.leadership. It’s at the Hasso Plattner Institute of Design, Stanford’s famous “d.school”. It involves design thinking — the “human centered” method of approaching problems that has roots in product engineering, but has mushroomed across the tech world and beyond.

But it wasn’t a class about learning design thinking. There are other courses for that, and this one assumes you already know most of your stuff.

It also wasn’t a class about coaching design thinking. There are specific classes for that too.

It included both of those things, but it was a whole lot more.

There are elements of this course that seem more real than any of the d.school classes I had encountered. They match us in pairs with a real organization with a real team, whose members have a real problem they’re trying to solve in the real world, with you as their real leader.

The time commitment was also very real, but I decided saying yes to this would make it worth saying no to the other things I had planned to do that quarter, so I applied.

When I got past the interview stage (yes, this class has an application that includes an interview), I felt privileged just to be accepted. They asked us to confirm that we would honor our commitment to see the class through.

I looked over the cliff and jumped.

On day one, we met our “d.leader” duo partners for the first time. We knew nothing about each other until the morning we got started and we were suddenly spending much of the quarter — and our lives — together. I was lucky with my pairing: an innovative Stanford Computer Science major (and Varsity softball star!) named Kristina.

That first week, we went through several “design cycles” to hone our knowledge of the design thinking process. We worked on “frames” which are points of view based on conversations with real customers, as well as concepts in response to what we discovered. Then we wrote our findings on oversized pink and blue sheets and stuck them on a whiteboard in exchange for some brutally honest feedback from the class. No one understood the ideas we wrote up, which made us vow to be clearer in future. It was intense, but a very quick way for Kristina and me to learn to work together.

The second week we met the people from our pre-assigned partner organization for the first time. Our team was the Stanford Blood Center, whose design challenge was trying to build a new generation of donors — a tall order.

The first session would be a whopping eight hours long with the partner team and us two “d.leaders.” By the end of the day, we were supposed to send back two problem frames and two concepts that our team had created — what we did in one week condensed into one day with a team we’d never met.

What we did in that session was up to Kristina and me to design, but we set our expectations high and planned out every 15-minute increment, in what the d.school calls a “Tick-tock.”

The night before the session, I woke up a few times with the weight of the responsibility. These are busy people with important jobs that help sick people get the blood they need to survive. They’re devoting a full day of company time to spend a day with us and it’s up to Kristina and me to make it worth their while. Not to mention the “homework” we were supposed to deliver by the evening — two concepts and frames posted to the class Slack group.

Design Thinking is all about moving quickly to gather insights and rapidly test out ideas to learn what works and what doesn’t. A blood center is a process-driven organization built around medical procedures with strict rules and regulations. Our contact at the center told us in a call the day before that it would be really hard to speak to donors without pushing through a whole lot of red tape and weeks of planning. This whole thing depended on interacting with users, so we worried about what we could do.

With materials from the d.school, we walked them through the design process and had them jump in right away. They grew comfortable with the idea of talking to donors and we all drove out to a blood donation center in a quiet part of nearby Menlo Park. The blood machines whirred and clicked in the background as the team members gently asked donors to talk through the specifics of a recent donation in what we call “empathy interviews.”

While one man was donating platelets down a winding reddened tube, he told us he was once so scared about the process that he compared it to a time he got exhausted kayaking in the San Francisco Bay. But that experience made him want to come back to the donation center and get over his fears for good. That was the kind of visceral description that is gold for designers. It made it easy to create a frame and come up with potentially game-changing concepts that might help others like him change their relationship to fear.

We quickly got into the rhythm of the work: Intensive classes for Kristina and me at the d.school followed by design experiments at the Blood Center, doing our best to push the team beyond their comfort zone with each session. And they were getting all kinds of insights from the empathy interviews with donors.

There was the atheist woman who said donating was her version of a religious rite — only she “gave blood instead of drinking it.” What if people could make donating be a kind of secular ritual?

There was the donor who felt ashamed when she found out she was ineligible to give blood. What if she could still make a difference when she showed up by recruiting other donors on her behalf? And there was Charles, our donor from the first day, who compared it to a scary time kayaking. He became a source of inspiration for many of the concepts, which we iterated on throughout the class.

At one point, we noticed team members were clinging to their office roles and often pitched ideas rooted in the world of their regular jobs. So Kristina and I came up with a game we called “Different Hat.” We asked everyone to use a sticky note to write down the job they really wanted when they were a child. We put the stickies into a hat and everyone picked one that wasn’t theirs. From that point on that was their “role” for the rest of the session. The marketing manager was now a marine biologist, the blood analyst was now a pastry chef. It led to some outlandish ideas, but plenty we could try out, too.

The d.school teachers showed us something called “analogous exploration,” where you look at a totally different activity to see how someone else deals with a problem like yours. We brought the team to an indoor skydiving center to see how its staff deals with fearful customers like our Charles — only this activity involves free falling on a blast of air rather than getting a needle in the arm.

There was much about the course that we didn’t expect before starting, and even halfway through we sometimes had no clue what would come next. But that’s kind of the point with this work. You’re trying to navigate a way forward when you can’t see much of the path ahead.

In our last week of the class the news broke that a novel coronavirus had jumped to the US and was spreading fast throughout California. In fact, the first death from Covid 19 was recorded in Santa Clara county, home to both Stanford and the blood center. The pandemic was underway and the university was about to make classes virtual. The blood center team was still going to work and they showed up for our last week of sessions, but with far more on their plates than usual. Our final Design Review was just a few days away and instead of the free flowing, in-person presentations, the school announced they would all take place via Zoom. We did our virtual preparations together to get the team ready for the presentation. Students aren’t allowed to take part in this one; we needed to lead our teams to the point where they fly solo.

The Stanford Blood Center Team presenting their final Design Review via Zoom days before the Bay Area’s shelter-in-place order.

And they soared. They told the story of Charles and the novel prototype they designed around the insights his experience generated: a live demonstration of a blood donation in front of an audience of strangers to see how it affects fears. While that didn’t quite stop people feeling afraid, the team learned that the confidence of staff did have a measurable effect.

There was another win to celebrate. Our team convinced a rules-driven organization to do something they’d never done before: take donations entirely in the open air, which could be a game changer for future mobile drives. And all the interest meant the staff recorded a non-trivial uptick in donations during that drive to boot. The d.school teachers were impressed.

The next week, the Bay Area’s shelter-in-place orders came down and nobody was going anywhere. The blood center was about to face one of its most uncertain times. In a recent follow-up call, they told me this work helped them get through it. For one, spending so much time looking at donors dealing with fear helped with outreach in the most fearful of times.

I wasn’t sure what we’d learn in a class about designing for unknown challenges, but it turns out teaching it really helps.

I learned when it’s good to intervene and when it’s best to step back in the training process. In the beginning, Kristina and I did much of the work to model how it’s done, but once we felt the fire was starting to blaze, we could stop trying to fan the flames.

I learned how powerful it can be to get people focused on concrete observations when abstract notions hold you back from looking at new ideas. Ideas became easy to brainstorm when we had one specific blood donor in mind with one particular problem.

And I learned that I’m pretty good at turning that sense of responsibility into action by making sure we had a solid plan for each of our team sessions in advance.

Leading a team you’ve never met before sounds like a strange and daunting thing to sign up for, but getting them comfortable with taking risks, joining them on an ambiguous journey, and seeing them come up with solutions that have a shot of lasting after you’ve gone is infinitely satisfying.

See my bio and contact info if you want to get in touch!

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Jim Colgan
JSK Class of 2020

John S. Knight journalism fellow. Previously Audible, SoundCloud, WNYC.