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MONDO ARC

The power of darkness

issue 43 Jun / Jul 2008


Neil Knowles, founder and Director of Elektra Lighting Ltd, Talks of the importance of darkness and the folly of overlighting spaces.

Interiors of all descriptions are routinely overlit. There is no need for these absurdly high levels of light and we would all benefit from darker spaces. In this article we will examine the rise of too much light, and how darkness rather than light can be used as a positive design tool, together with the benefits of doing so.

It is important to note in this context that bright and dark are relative terms. They need each other to exist. The contrast theory of meaning (Ernest Gellner, Words and things, 1959) states that objects can only be understood with reference to their opposite; for example  if everyone was tall, no-one would think of themselves as tall, just normal. You need a reference point, a short person to look down on. Similarly, there can be no light without dark. It should also be noted that darkness is relative in magnitude as well. What we mean by dark depends on how bright the light is and the relative light levels. A dull grey day could still register 2,000 lux in absolute terms, very high for an indoor space but very low compared to the 100,000 of a sunny day.

Historically, spaces were much darker than they are now. Shops for example were lit by candles or gas lanterns. In recent years there has been an inflation of light levels - an arms race of illumination. We only need look a few years back in time to see how high and how arbitrary the current recommended light levels actually are.

Almost without exception, there was a steady increase in recommended lux levels from the 1930s to the early 1970s.

Among the more dramatic cases, the UK’s retail lighting level recommendations increased from ~100 lux in 1936 to ~500 lux in 1972.

In the former Soviet Union, the recommendation for general office lighting was ~25 lux in 1930, but had risen to 300 lux by 1979.

In North America, recommendations for chalkboard lighting rose from ~150 lux in 1938 to 1,400 lux in 1972.

Limited evidence indicates that levels were even lower prior to 1930, e.g. 35 lux for detailed drafting in 1915.
(American Energy Efficiency lighting association figures)

Our eyes, it should not be forgotten, happily work at levels between 0.1 to 100,000 lux, and they will compensate for any increase. If 1 lux is ok for safe movement in an emergency, why do we need 100 lux in corridors normally? Part of the reason for this increase is the risk – averse culture. If in doubt, ‘overlight it’ seems to be the motto, and we are terrified of being sued if someone trips up.

The benefits of less lighting are immediately apparent. Firstly, spaces will look better – more interesting and more evocative. Uniformly bright spaces are uniformly bland spaces. They present a washed-out appearance, lacking in focal points and the high light levels remove any drama. Leaving whole areas dark but lighting specific points creates more dramatic spaces (the “play of brilliants” as Richard Kelly would have called it). In addition, there are many effects you can only do in the dark, such as image projection. Simple things such as mood are more easily created with a blank canvas – a candlelit restaurant will only work in the evening; in lunchtime it is only a restaurant with candles, a significant difference.

Secondly, less light means less energy required to produce this light. If we stop lighting retail areas to 1000 lux and instead light them to 100 lux, we have achieved an immediate 90 % saving in energy use, with equivalent savings in CO2 emissions, starting us down the road towards a more sustainable future.

It can be seen therefore that we could and should light our buildings a lot less than they are lit. But what are the possibilities and what are the effects of the various types of darkness? In this next section we discuss the possibilities.

Dark ceilings lower the apparent height of the space. This in turn creates greater intimacy and allows focus to tables, or verticals – creating a more luxurious feel if you have expensive wall coverings. There are of course night-time parallels – at night the outdoor “ceiling” is dark, and our evolutionary history has adapted us to this environment.

Alternatively, the walls can be left dark. Keeping a lit ceiling and a lit floor is the default hotel lighting design with downlights and coffers. This solution allows you to add colour to ceilings and drama to floors or objects and to create an intimate space that is also quite bright.
A dark floor makes a space light and airy space but without being overlit. If the floor here was lit as well, it would be too bright but as it is left darker, the space works.

A dark floor and ceiling creates a bright lit space with a relatively low light level. It paradoxically makes space seem bright whilst not being lit brightly. I have used this effect at more than one project where practical considerations prevented lighting to or from the ceiling; we simply washed the walls brightly to compensate, and the space appeared bright whilst having a lux level on the floor of around 10 lux – greatly below guidelines.

Dark sections are a more dramatic example of darkness. One area is left entirely dark, others are bright. The light at the end of the tunnel is the best example of this, the sense of adventure and discovery created is palpable.

How then, to best achieve a lower-luminance world? Asking companies to adopt lower light levels might work, but would be too slow. Legislation is the only answer. In the UK it would only take a small tweak to Building Regulations to achieve this, and a lower carbon future is ours. For example, we could limit energy use for lighting to a maximum wattage per square metre, such as 10 watts/m2. for retail areas, with no exceptions. This could easily allow for drama, interest and accenting – as long as you adopt maximum light levels of around 50 lux for ambient lighting. This would save around 80-90 % of retail lighting energy costs immediately.

Offices should be limited to 50 Lux maximum, with supplementary lighting on desks allowed if you actually want to read a paper document – in this world of internally lit screens with documents, emails and CAD drawings, you don’t actually need much light on the desk at all.
In conclusion, I would like to say that by their contribution to global warming, high light levels do much damage to the environment. It is time we stopped overlighting buildings, time we used less light, and time we stopped being afraid of the dark.

www.elektralighting.co.uk

 

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Posted By JamesFam 1 September 25, 2016 10:05:42 PM

The first patient I ever saw as a first year resident came in with a litany of complaints, not one of which I remember today except for one: he had headaches. The reason I remember he had headaches isn't because I spent so much time discussing them but rather the exact opposite: at the time I knew next to nothing about headaches and somehow managed to end the visit without ever addressing his at all, even though they were the primary reason he'd come to see me. Then I rotated on a neurology service and actually learned quite a lot about headaches. Then when my patient came back to see me a few months later, I distinctly remember at that point not only being interested in his headaches but actually being excited to discuss them. I often find myself thinking back to that experience when I'm confronted with a patient who has a complaint I can't figure out, and I thought it would be useful to describe the various reactions doctors have in general to patients when they can't figure out what's wrong, why they have them, and what you can do as a patient to improve your chances in such situations of getting good care. THE SCIENTIFIC METHOD Believing a wacky idea in and of itself isn't wacky. Believing a wacky idea without proof, however, most certainly is. Likewise, disbelieving sensible ideas without disproving them when they're disprovable is wacky as well. Unfortunately, patients are often guilty of the first thought error ("My diarrhea is caused by a brain tumor") and doctors of the second ("brain tumors don't cause diarrhea, so you can't have a brain tumor"), leading in both instances to contentious doctor-patient relationships, missed diagnoses, and unnecessary suffering. Doctors sometimes aren't willing to order tests that patients think are necessary because they think the patient's belief about what's wrong is wacky; they sometimes suggest a patient's symptoms are psychosomatic when every test they run is negative but the symptoms persist; and they sometimes offer explanations for symptoms the patient finds improbable but refuse to pursue the cause of the symptoms any further. Sometimes these judgments are correct and sometimes they're not---but the experience of being on the receiving end of them is always frustrating for patients. However, given that your doctor has medical training and you don't, the best strategy to use in these situations may be to do your best to ensure you're being handed judgments based on sound scientific reasoning rather than unconscious bias. EXPERT VS. NOVICE THINKING But even the most rational scientist is teeming with unconscious biases. So an even better strategy might be to attempt to leverage your doctor's biases in your favor. In order to do this, you first need to know how doctors are trained to think. Medical students typically employ what's called "novice" thinking when trying to figure out what's wrong with patients. They run through the entire list of everything known to cause the patient's first symptom, then a second list of everything known to cause the patient's second symptom, and so on. Then they look to see which diagnoses appear on all their lists and that new list becomes their list of "differential diagnoses." It's a cumbersome but powerful technique, its name notwithstanding. A seasoned attending physician, on the other hand, typically employs "expert" thinking, defined simply as thinking that relies on pattern recognition. I've seen carpal tunnel syndrome so many times I could diagnose it in my sleep---but only learned to recognize the pattern of finger tingling in the first, second, and third digits, pain, and weakness occurring most commonly at night by my initial use of "novice" thinking. The main risk of relying on "expert" thinking is early closure---that is, of ceasing to consider what else might be causing a patient's symptoms because the pattern seems so abundantly clear. Luckily, in most cases, it is clear. But sometimes it isn't. In those cases, your doctor may do one or more of the following things: 1. Revert to "novice" thinking. Which, in fact, is completely appropriate. We're taught in medical school that approximately 90% of all diagnoses are made from the history, so if we can't figure out what's wrong, we're supposed to go back to the patient's story and dig some more. This also involves reading, thinking, and possibly doing more tests, for which your doctor may or may not have the stamina. 2. Ask a specialist for help. Which requires your doctor to recognize he or she is out of his or her depth and needs help. 3. Cram your symptoms into a diagnosis he or she does recognize, even if the fit is imperfect. Though this may seem at first glance like a thought error, it often yields the correct answer. We have a saying in medicine: uncommon presentations of common diseases are more common than common presentations of uncommon diseases. In other words, presenting with a set of symptoms that are unusual or atypical for a particular disease doesn't rule out your having that disease, especially if that disease is common. Or as one of my medical school teachers put it: "A patient's body often fails to read the textbook." 4. Dismiss the cause of your symptoms as coming from stress, anxiety, or some other emotional disturbance. Sometimes your doctor is unable to identify a physical cause for your symptoms and turns reflexively to stress or anxiety as the explanation, given his or her awareness that the power of the mind to manufacture physical symptoms from psychological disturbances is not only well-documented in the medical literature but a common experience most of us have had (think of "butterflies" in your stomach when you're nervous). And sometimes your doctor will be right. A physician named John Sarno knows this well and has a cohort of patients who seem to have benefited greatly from his theory that some forms of back pain are created by unconscious anger. However, the diagnosis of stress and anxiety should never be made by exclusion (meaning every other reasonable possibility has been appropriately ruled out and stress and anxiety is all that's left); rather, there should be positive evidence pointing to stress and anxiety as the cause (eg, you should actually be feeling stressed and anxious about something). Unfortunately, doctors frequently reach for a psychosomatic explanation for a patient's symptoms when testing fails to reveal a physical explanation, thinking if they can't find a physical cause then no physical cause exists. But this reasoning is as sloppy as it is common. Just because science has produced more knowledge than any one person could ever master, we shouldn't allow ourselves to imagine we've exhausted the limits of all there is to know (a notion as preposterous as it is unconsciously attractive). Just because your doctor doesn't know the physical reason your wrist started hurting today doesn't mean the pain is psychosomatic. A whole host of physical ailments bother people every day for which modern medicine has no explanation: overuse injuries (you've been walking all your life and for some reason now your heel starts to hurt); extra heart beats; twitching eyelid muscles; headaches. 5. Ignore or dismiss your symptoms. This is different from the application of a "tincture of time" that doctors often employ to see if symptoms will improve on their own (as they often do). Rather, this a reaction to being confronted with a problem your doctor doesn't understand or know how to handle. That a doctor may ignore or dismiss your symptoms unconsciously (as I did with my first-ever patient) is no excuse for doing so. A DOCTOR'S BIASES Just which of the above approaches a doctor will take when confronted with symptoms he or she can't figure out is determined both by his or her biases and life-condition---and all doctors struggle with both. To obtain the best performance from your doctor, your objective is to get him or her into a high a life-condition and as free from the influences of his or her biases (good and bad) as possible. Negative influences on a doctor's life-condition include all the things that negatively influence yours, as well as the following things that may happen to them on a daily basis: 1. They fall behind in clinic. Your doctor may be naturally slow or frequently have to spend extra time with patients who are especially ill or emotionally upset. 2. They have to deal with difficult or demanding patients. Hard not to enter into a defensive, paternalistic posture when too many of these types of patients show up on your schedule. 3. They feel like they don't have enough time to do a good job. With fewer and fewer resources, doctors are being asked (like everyone) to do more and more. 4. They have to deal with a morass of paperwork in a hopelessly inefficient health care system. The amount of time most doctors must spend justifying their decisions to third-party insurance carriers is growing at an alarming rate. A sampling of unconscious biases that influence doctor behavior include: 1. Not wanting to diagnose bad illnesses in their patients. Leading sometimes to an incomplete list of differential diagnoses. 2. Not wanting to induce anxiety in their patients. Leading sometimes to insufficient explanations of their thought processes, which often paradoxically leads to more patient anxiety. 3. Over-relying on evidence-based medicine. Though the practice of evidence-based medicine should be the standard, many physicians forget there's a great difference between "no evidence existing in the medical literature to link symptom X with disease Y" and "no evidence existing to link symptom X with disease Y because it's not yet been studied." 4. Not liking their patient. Leading to impatience, not listening, and not taking enough time to think though the patient's complaints. 5. Liking their patient too much. Leading to biases #1 and #2. 6. Thinking a patient's symptoms are caused by one diagnosis instead of many. Also known as Ockham's razor, sometimes it's true and sometimes it isn't. 7. Wanting to be right more than wanting their patient to get better. Res ipse loquitur (the thing speaks for itself). 8. Believing their first thoughts about the diagnosis are more likely to be correct than any subsequent thoughts. If your doctor is too attached to a diagnosis simply because it's the one he or she thought of first, or has seen it more than other, less common diagnoses, he or she may avoid pursuing other possibilities. 9. Failing to consider that a test result may be in error. This doesn't happen commonly, but it certainly does happen. 10. Wanting to avoid feeling ineffectual. Some diagnoses are more amenable to therapy than others. No patient wants to have an untreatable illness and no doctor wants to diagnose it. 11. Having an aversion to being manipulated. Manipulation is especially common in patients suffering from chronic pain syndromes (who may at times appear drug-seeking rather than pain relief-seeking). No one likes to be manipulated, but a wise mentor of mine once said, "The question isn't whether or not your patients will try to manipulate you. The question is how will they try to manipulate you." Coming to terms with this truth is vital for any doctor to have successful relationships with their patients. HOW TO GET YOUR DOCTOR ON YOUR SIDE Unfortunately, your ability to raise your doctor's life-condition is as limited as your ability to raise anyone else's, and even more so when you don't feel well. Good humor, if you can muster it, may be your best option. But in dealing with your doctor's biases, you have on your side a fact I firmly believe to be true: most doctors want to do a good job and help their patients as best they can. So what exactly can you do to maximize your doctor's ability to help you? 1. Position your symptoms and requests carefully. Don't demand medications or tests. Ask about them. Wonder about them. It's perfectly all right to bring up research you've done about your symptoms, but explicitly express your openness to the possibility that your ideas might be wrong. Not that you should aim for subservience by any means, but rather for a genuine partnership. 2. Remain reasonable even when you're irritated. Most doctors, even when stressed, will respond to reason and reasonableness in kind. 3. If your doctor suggests your symptoms might be due to stress, acknowledged they may be right. Even if you disagree. First of all, your doctor may be right, even if it doesn't feel that way to you. Secondly, if you dismiss the notion out of hand, you might make your doctor defensive and therefore more likely to cling to an idea that a moment before was only one possibility among many. 4. Ask questions that promote transparent, logical thinking. Many doctors don't explain their thought processes clearly. Write all your questions down before your visits and ask smart questions that actually help your doctor think through your symptoms and his or her approach to working them up ("What possibilities will this test rule in or out?" 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