Unfinished Conversations #2

Design is an attitude – and this comes about through conversations, arguments, trust and courage. What becomes visible in the end is the finished work, a product, an oeuvre. What is, however, no longer visible are the people who worked on it, who wrestled and fought for months and were convinced of the thing when it was still not real. It is, however, precisely these people whose skill lies in design. They are the ones who made the thing possible in the first place.

That is why we are continuing our series of conversations in which the invisible, the human being, is given a face. We don’t want to tell any success stories and we don’t want to recount what people often like to read about themselves. We do not want to provide any steadfast structures and conclusive explanations. What we want is to show what life is really like. What relationships are really like. Lively. Illogical. Volatile.

This book is a sequel – once again unfinished, of course, and it is an experiment. That is the way it is when you start an experiment with an unclear outcome. At the same time, it is also a thank you. To all people those who soldier on and take care of our health every day.

 

 

Dr. Marc Becker
Bold

Michael Keller
Regular

 

 

Marc, the motto of your work is – behind every test there
is a human being. What does this sentence mean to you?

I worked for my father when I was a schoolboy. It was the time when they introduced newborn screening and maybe it was that which triggered something inside me – I saw what a lever we had in our hands to change something in this field. Screening means that I can find something before a patient really feels the effects of a disease. If, with the help of newborn screening, I find a condition like phenylketonuria*, it means that the child will have to follow a different kind of diet until he or she is eleven or twelve years old, then afterwards he or she will be able to lead a normal life. Yet if I don’t find it – the child will not be able to attend a normal school, never be able to take his or her high school graduation exam because they have not gone through the normal learning process. I work in the field of laboratory medicine, we don’t really heal anybody, we simply enable the right therapy to be administered. I have always been totally fascinated by that. The other thing – having to treat a sickness – I don’t find exciting at all.

If you put it like that, it sounds incredibly exciting, but your everyday routine is more of a technical nature. For example, you never get to know your patients.

I have no problem with the fact that as a laboratory clinician I do not get to know my patients, but nevertheless I can still make a difference in their lives.

… you have now been working in the field of health for three generations.

It’s as if my father and grandfather had drawn a line that suddenly stopped at some point – and I then took up the pen and continued to draw it.

Would it be different if the two of them had never existed?

I don’t know – if so, I would be someone else. The fact that my grandfather and my father existed gives me the feeling that I am continuing something without me having had to manage what was already there.

And to what extent does that still affect you today?

I feel incredibly free from both of them, this is a nice feeling. I would like to be able to deal freely with the work I am doing so that it will continue to be relevant. I could say: … one patient behind every test, but the good thing is I have now learned to say freely – no, we have, at some point, to strive towards carrying out fewer tests.

Freedom means making mistakes, learning from them and using them to also stay vibrant.

Do you forgive yourself for the mistakes you make?

Yes, because the good thing about mistakes is that you can learn something from them. I once did a stint of clinical training with a renowned surgeon and he had a very nice definition for mistakes or stupidity: somebody who makes a mistake twice is stupid, but making a mistake once – is allowed.

I agree.

(both laugh)

My family has a saying on our front door: We don’t make mistakes, we do variations. But you always act so perfectly – perfection seems to be important to you. I can still remember how upset you were about a typo in an internal paper – OK, I admit there were actually three spelling mistakes.

Perfection – or rather precision – is actually very important to me, otherwise I wouldn’t be able to do the job I do. I do, however, always take small steps, because then the mistakes I make are not so noticeable.

It’s very different with me. I always need the whole picture and my imagination takes hold. I create big pictures – and if things go wrong, then I need a big idea quickly.

And somehow it’s also kind of fun to try things out. I am a laboratory clinician, everything I do is based on experiments. And in the field of laboratory medicine things have certainly gone wrong hundreds of times; we plugged away for so long until we achieved something what today we can call precision.

There are also no mistakes when it comes to art. It is simply … did it work? – did it not work?

I do believe that an artist works on a piece for a long time – we just don’t see how long or how much, we only see the finished product. If you have a test done by me, you don’t see the decades and centuries it took for the development of the medical technology behind it. In laboratory medicine, as in art, in the end you only see the finished work.

Trying things out is part of the process. That is the way it is done.

Yes, and that’s why I’m equally as excited about laboratory work as I am about art. When I think of the artist – so much has to be done before he can accept his picture? When I think of Pat Steir*, for example, she painted with an element of chance – she created a system that narrowed down the element of chance without controlling it so that she can accept what ever happens next. She knows exactly when she makes a curved stroke with her brush, how fast any particular pigment will run, exactly what the mixture has to comprise of. And when it comes to laboratory medicine – yes, we also create external conditions, but I cannot control the reaction. I don’t know how much of an enzyme is in a test, but that is exactly what makes it so exciting, I am the one who makes it visible.

Your connection with art – how did it come about?

My grandfather liked to collect objets d’art and we grew up with his collection. He was never interested in any particular epochs or styles, but everything was of a very strong quality. Nevertheless, my grandfather’s collection in itself bore no particular relevance for me. But the one good thing it did for me was to enable me to be touched by art. The fact that I became aware that I actually needed this – that was the work of my grandparents and my parents. Through them I discovered a love for art and also for music. And it was the same with medicine, too. It was a long and rocky road I had to go down, but meanwhile it has become part of me.

In the field of art, the artist stands alone, but in the laboratory you need a few sparring partners for development. How important are others for you?

They are essential. I can’t go it alone. I believe very strongly in the „we“. I believe very strongly in community. If I think of my laboratory and my staff, they are all a lot better than me, and that’s the beautiful thing about it.

How do you find these sparring partners?

I think you can learn something from everyone. If you compare health to a game, it is not a game in which you get first, second or third prize, but it’s a game that is all about staying in the game.

In this light then there is no first in this game, you never stand on the winners’ podium – or every day you are healthy, you are actually on the podium … wanting and being able to stay in the game is also quite a challenging demand, isn’t it?

Yes, for an entrepreneur, that’s an incredibly challenging demand. What many are not so aware of, however, is that health is actually a never-ending game …

… with a very definite, clear ending … (quietly)

… a game in which one drops out at some point. You can’t be the healthiest person on Earth, you can live a healthy life, but that does not mean that you are healthy and that you will stay healthy.

Are you religious?

Well, yes.

How does this express itself?

I really like ethics. The principle of self-love and charity. I believe very strongly in treating my fellow human beings as carefully as I treat myself.

After spending 216 days in hospital last year, I thanked the medical professionals who were 49 per cent responsible for saving my life; they often found it hard to believe that somebody would want to thank them. And the other 51 per cent I put down to my own, personal energy and my belief in the joy of life.

Doctors often use the expression “to guide a patient”, but the patient must also want the right thing. Yes, there are certain cases in which the doctor can intervene curatively, but in many cases it is up to the patient. I believe your case was a very extreme example. When you think of all the things you went through and how often you had to make decisions to turn left or right and how often you could have said „I’ve had enough, I can’t go on“. I am really impressed by that. Maybe 51 per cent is in fact an understatement.

How do you learn it, this belief of yours?

You have to have a longing, a passion, to know what you’re doing something for.

That sounds more like a conscious, rational approach. Do you trust more in your head or in your gut feeling?

I am a head person who has learned to listen to his gut.

How long have you known this?

For a couple of years.

(both laugh)

How important is the past for the future?

I once had a work that I studied for a long time. It consisted of 18 sheets of music; it was Lohengrin and – you’d like it – incredibly strict, framed in black. And then the artist painted it over with black oil pastel, in the style of Richard Serra*. That brought about its own sense of rhythm. I was incredibly fascinated by the fact that I had had such a great past and was now able to continue this by creating something new. I do not know how I can put it in words for you.

Why is it that you can appreciate health so consciously?

I am happy that I can move, that I can think, that I can do everything the way I want. It is more than just an absence of illness. Health is for me the basis for vitality, and I would like to be vital for as long as possible. And, you know the story of my father who benefited from medical advances throughout his whole life. In 1984 he got his first heart valve with a kind of aorta replacement; he was never really healthy, we always had to take care of him. And that’s probably why I have such a relationship with health. It’s like a foundation which spawns vitality. In my father’s case, the foundation was just a little smaller.

Did you ever go through a period when you were not so vital? How did that feel?

I once went through a time when I had too much work, I no longer knew what longing was – it was like walking a tightrope, because I could have fallen in any direction. There was my family with my daughter, there was the relationship with my wife, there was work and there was me personally. And somehow I had to keep my balance, and not lurch in one direction or the other. If you can somehow manage to keep your balance, and that is indeed hard work, a form of strength, that then feels good.

How important is asceticism?

These days we live our lives in a state of abundance, and it might well be a good exercise for once to be aware of doing without something in our everyday life and to realise that you can get used to this sacrifice. But … going into retreat at a monastery – that is not what I need in my life right now.

But you have obviously been thinking about it?

I think it is a really exciting idea, but more because I see a challenge in it.

It is probably also the love for Wolfgang Laib*⁴ that we both share. He wallows in a state of silence and concentration when collecting his pollen; the ultimate dream of being in a meadow one day and only to collect flowers.

Your dream.

(both are silent)

You would probably call it longing … screaming on the inside …
is that my dream? But that would definitely be something which would enable me to see what then might happen in my life. I would like to know how much I would then change. Would I then be freer?

Freedom is just a feeling. I feel free when I sometimes – once a week – have time for myself. And sometimes I need something more to feel free. But back to this flowering meadow again … Would you be satisfied with that?

At the moment yes.

And would you have felt like that two years ago?

No. I couldn’t have described it two years ago. And today, logically, through what happened to me, or through the gift I received, material things are no longer of any value to me. It’s all just projection. At the moment my longing would be to sit cross-legged in a meadow full of flowers and meditate and collect pollen – ok, I can’t do that (laughs). In the case of Wolfgang the real work in hand is to spend time with yourself. The focus is not on the work of art, but on the result of his own meditation.

That’s what I think is so great. He gives meditation a symbolic value. He’s giving away some of his time. That is so touching for me. One can imagine how long it took him to collect all those flowers. And that is what I think is so moving about all the pollen. He gives of himself something very essential – and that is time.

That’s right, time. What does it mean to you?

In this case, I’m very much in line with the sophists. Time is the most precious thing I have – and, unlike my bank account, I never know how much time is available to me. I don’t even know how long I am going to exist in this state of being alive. That’s why I just want to enjoy what vitality I have and use it for as long as possible.

The way you put it is very nice. I think I always wanted to be first, number one. That’s why I’m so overwhelmed that I am still around now, that every minute is a gift. You’re giving me time right now, and that makes me humble in this situation. It is so precious. I didn’t understand that before – how did you come to the realisation?

When I was with my father and it was really quiet – in the theatre, at a concert or on other occasions, then I heard his heart valve ticking.

No … you don’t mean that seriously …

(takes a deep breath)

It was a mechanical heart valve. It sounded like a clock.

Oh well, thank you for sharing that experience with me.

(whispers)

Once, on the first anniversary of my father’s death, I calculated how often it had ticked … and realised just what a great gift it was.

(reflects)

That sounds so brutal … (whispers)

Yes, but somehow so beautiful, too. You have to imagine – in 1984 a new heart valve, I was four years old – you just asked me what health means to me. I would probably not have become a laboratory clinician without my father, we probably would never have met, I would be a completely different person – and the whole thing can be traced back to this ticking.

That’s insane …

(a pen can be heard striking a glass)

There is more to this gift than the few million times the heart valve ticked. The path I took in life was also given to me by the person who operated on my father and who I don’t even know – I got the gift of 30 years of life with my father; I can hardly complain about that now.

(looks up)

That’s crazy! On the one hand, everything is in the here and now – there is no more time – everything merges into one. And yet on the other hand a certain form of mechanics is involved – like a timepiece that gives people life, especially your father.

Yes. That’s the way it is – when we contemplate something it is often the case that it dematerialises as soon as the ground has been pulled away from under it. Health is not a gift of God that will last forever. Then a lot of things are no longer so important. I think everyone would give a lot just to be healthy, to regain one’s health again after an illness or to stay healthy …

… people would do anything for that … anything … (quietly)

And you then also notice that the intrinsic value of life repositions itself and relationships, friendships – all those things are suddenly classed differently than being mere possessions. It is not for nothing that many people who become very sick feel the need to travel – to experience, to discover new things. That has a lot to do with being alive – just as it is in relationships. What could be more lively than spending an evening with Michael Keller?

(both laugh)

Time enables us to enjoy the best form of relationship. Relationship has taken on a different status for me. Although I have lived with my wife for 40 years, the interpersonal relationship has become even more important. I love the conversation, I love the energy. I have, however, realised that I can only give something when I have received something myself.

Yes. That means that you are present, that you are there. Second class time is when you’re just not there at that moment.

Yes, but why, when we have realised this, have we not managed to turn the world around? Why can’t we do more for our health?

There are two sides to health. One part of health is the one we are responsible for. And the other part of health is the one we can’t choose. You didn’t choose your disease, either. Probably a cell somewhere turned left and you couldn’t have prevented that. There is, however, the side of health that I myself can control. And it has something to do with my liveliness, my vitality. There is an experiment – you can either have one cookie now, or you can wait ten minutes and then you get two cookies. There are some people, however, who take one cookie and they are the ones who are going to have a harder time maintaining their health. Why should I forego a cookie now – so that I will still be fit in ten years’ time?

Nice example … (quietly) It’s a pity though that nobody tries to get this positive health message across to people. I have the feeling that we still learn too little about health in school. How do you deal with the fact that in the current situation society is divided into two camps when it comes to health?

I think the other part of health – the one we don’t have under control scares us. And I believe, many are just scared.

Are you fearless?

No.

(Michael laughs)

Why, not?

Fear has a lot to do with humility. When you are faced with something you are afraid of, you know exactly what it is that scares you. This helps you to develop some form of protection and that also makes us cautious.

Back to the part of health for which we ourselves are responsible. Does it also involve fear – or anxiety?

Fear is definitely involved. The path we take to make sure that we stay as healthy as we are now doesn’t guarantee that we will stay that way.

And when my alter ego decides it just wants to stop, when my heart decides it does not want to beat anymore, then the story is over. I think maybe we should talk more about the fact that everything is a gift and therefore we do not have the right to claim that that’s the way it is. When you are given the gift of a second lease of life then it would have to lead to a reaction in which I say, „Hey, I felt it, fear!“ and then I would have to say, „Hey, health is so great, life is so great! And that should actually positively translate into, „Hello fear, welcome!“ – and not, „I’m afraid!“ Even better would be, „I have a feeling that makes me afraid! – but that’s ok.“ It is important to pay attention to how you feel.

Yes, paying attention is vital.

So vital. This year a long-term employee of ours, Daniel Melzer, died. He was only 36 years old and he had had bronchitis, but had not given himself enough time to recover from it. We miss him very much, and it is inconceivable that having a blood test might have saved his life.

Here I would like to make a small personal wish – please don’t be heroes, have yourselves tested regularly – I think I can get this across here with all my heart!

Paying attention is so fundamental that it can become a mindset. Do you think we can develop and practise a mindset?

I think so. Don’t you think so?

Definitely. I find that you develop a basic mindset in the parental home, and then you decide which roads you want to go down: What does charity mean to me? How do I deal with truth? What is truth? Am I a believer or not. Then you are faced with the decision – as you put it so correctly – to turn to the left or to turn right. Everybody is faced with this. And to be honest, I’m afraid you need a certain mindset every day, because you have to make choices every day.

If you have a certain mindset, does it help you a lot in situations in which you have to make decisions?

It’s actually an insanely beautiful internal compass. You just have to really believe in it. You can’t hold the compass needle down, you have to completely accept what it wants to do at that second and then just let go.

I believe that you can see a gift in everything. And if you do, you will go through life with a completely different mindset. Last year we had a moment when we no longer knew how orders would develop, whether demand would increase – we didn’t know if we had enough material to calculate how long liquidity would last, to be able to buy this material. And nevertheless I found that we still somehow came out on top.

 

How did you fare during the first Corona period?

We would never have been able to relaunch our brand if it had not been for Corona. There was something grounding about it and I am still grateful for that. We would not have made so many other decisions and I would never have got my life so organised. And for that I am totally grateful and I was allowed to be right in the thick of things.

How did you come to call me and say, Do you know anyone who is good at social media?

I felt like you had time.

(both are silent)

And I think you rarely have time.

(both are silent)

And I still had time at that moment. And then I thought to myself – that’s perfect.

You poor thing … full throttle for a year and a half? Did you know that you would kick off such a process?

No, I thought at the time it would be a good thing for everybody.

(both laugh)

No way could I have imagined that it would lead to this. That it would one day take on such dimensions – that’s why I was happy that it started to slow down a bit …

… dealing with yourself is exhausting – now it’s time to exhale.

It just kept on turning, over and over again.

In my view of the world, it’s like a family constellation therapy. Over the year and a half what was the most difficult moment in this self-therapy?

Just choosing the colour was a difficult process for me – that was something I thought about a lot over and over again, where we were coming from, where we’re going. The black logo, that was something I really liked, but it was not suitable for a lab. It was at that moment that I learned that I had to expand my horizons. The fact that I had suddenly become a pictogram – that’s not my thing, but I understand it.

The new style of illustration is one point, another is ultimately that the word “laboratory” had morphed into a graphical symbol, the “B”. And yes, it is also a symbolic visualisation of your vision for the company and your values …

… and that just keeps on developing. It is now our identity, it’s just us. And I always look forward to the findings. On the first morning after the launch I received all the test results from the weekend in paper form. I was happy to see that all the results from the process had now become visible.

I also got one on Saturday, too, and for about seven minutes I think I did not look at the findings and results at all, and I did not look at the orange „B“ for a single second – all I saw was your mindset. It was now the beginning of something completely different; for me it was like a binary code, you could now communicate with the whole world – the sky is the limit, the scale is upwardly open. What could I learn from you? You are in the midst of your
organisation, and this has enabled you to embrace something that is very important to you – scalability. Am I scalable, Marc?

No, you are not scalable. I believe the difference between us is – I have a Formula 1 team and I have to explain to its members – you have to make it a second faster. Or we might as well take the curve backwards. For me it is important to be upfront in the lead and not above. In the end, I don’t care who does what. I give support where I’m needed – even when I’m at the reception desk or putting tests into bags. I have learned, however, that sometimes it helps to explain who I am.

How relevant is the size of your company to you? We once had 120 employees and now we have 60, a size with which I feel very comfortable. How do you feel about this?

I don’t care – my goal is to create something that is bigger than myself, for example, again something like newborn screening.

(deep in thought)

How do you think it is with me?

(laughs)

With you it’s on the customer level, you can say that is not good enough for me now. Or we can do better. You are the founder. I inherited something that, with the benefit of hindsight, I feel I deserve. And sometimes that has something to do with respect …

… yes, but to what extent?

Well, that’s probably not so clear to many. But the laboratory got bigger and bigger. And then I hit upon the idea – what would my father now say to my grandfather? I never did really get into the administration side of the business, but, nevertheless, I’m still the generation that has taken it over. I have optimized it and developed it further. And then, of course, I was also lucky things went the way they did.

No, Marc, I see things differently. You know about my transformation to Blackspace, so I know what you’re talking about. And, yeah, I actually experience what you do. For me you are a founder. I want to give you back this energy – you remember when we were standing near that time clock and your 128 employees all passed you by in just five minutes? Not to mention the other 522 employees who work elsewhere or on the night shift.

No, you have every right to feel like a founder and to broadcast that, too. It’s just a mind game.

Still, the relaunch had a very special personal meaning for me – that was my personal Easter.

Yes, you said that it was the end of one story and the beginning of a new story because you are the founder.

(takes a deep breath)

It is Easter.

But I didn’t realize that when I called you. I think it’s so beautiful – in life so much comes back to you in very unexpected places, and it’s just so beautiful.

I will not forget it. This building was empty, that was the answer to your call. How are you? – You, the building is empty – and the next day a social media request for Mr. Keller who is just about capable of holding a pen in his hand and doesn’t know what a computer is.

(both laugh)

You then showed me what a specialist you are …

I then – thank God – showed you what a specialist I am.

(both laugh)

That’s true! But you did it after all. Yes, it was in our leisure time, but from a logical point of view by doing so you also gave me an incredible gift. The great thing about you is that you gave this gift without considering whether you wanted something back in return. This is the generosity of a lifetime.

When you give something, you don’t reckon with getting something back. It often comes back in a very different form. Sometimes it’s just nice to feel good about having done something good. And that has a lot to do with fulfilment.

It’s actually quite simple.

Yes, it’s that simple, Michael – but it was also pretty funny when you came to us …

Mega …

Do you know that it was the 4th of April? I know because it was the anniversary of my father’s death …

… the anniversary of your father’s death, I didn’t know that. (quietly) We were sitting upstairs in this conference room, which I can still remember as a different room to the one it is today – and it was also a day when I went home feeling blissful, because our togetherness had felt so good. With you there was a feeling of curiosity, humility and warmheartedness.

And I felt you were interested in getting something off the ground. Are you actually aware that you have a profession?

It’s really a calling. I’m what you might call a Jack of all trades, I think that’s really cool. At the moment I’m doing a little marketing, before that I did a little bit of sales – that is now at a stage where I can hand it over to someone else. I’m always ready to learn and design things, that’s nice.

Is it that what defines a classic, well-trained medical laboratory clinician?

I think people generally think that someone like that can make his laboratory an economic success (crosses his arms behind his head). But I don’t know if I’m good at making money. We have, however, definitely implemented a lot of good ideas.

But it’s not about money at all. We should find another currency or maybe other words, because money reduces everything to such a low level. If you do something that you are passionate about, then everything else will fall into place. Do you believe in chance?

I don’t know, I can’t really say, but it is certainly not chance that we met. Of course, we come across coincidences in life over and over again. It depends how you deal with them, because everything eventually will somehow fall into place. And as long as you have a system like Pat Steir or John Cage*⁵ lots of things fall into place. What I like so much about John Cage is how he accepts his art – all is well.

All is well.

And my thoughts just dwelled on the fact that sometimes in life we get stuck in the „I wanted, I want, I do“ phase – and at that moment when you stop doing that and allow things to take their course, then exactly the same thing happens, sometimes something even better. Many things fall into place by themselves where they were meant to fall into place. There is, in a sense, something greater.

Do you want to live or are you not afraid of death?

I don’t see a space anymore where I don’t see it – I want to live – I want to live so much.

And what is life?

The moment now – I need nothing more

(both reflect)

I am fully satisfied.

Yes, it is vitality. You should not put off anything in your life –
especially when it comes to vacations or things that you want to do – you just have to do them.

My last question: Is blood to you something like typography to us? Or – Do you get to know people better through art than through your work in the laboratory?

I don’t think the question is fair.

(looks at him)

The only thing I do is to look through a keyhole at a subject which involves me trying to get some information out of a person’s blood that will enable a third person, a doctor, to make the right decisions for the patient.

And for me it’s the typo – it’s nothing more than me stringing things together in the correct order to make what in the end will be a Christmas book that will give other people the opportunity to understand and possibly to live their life differently. And by having this conversation with each other, in absolute trust, I believe that we can change the world by not going it alone, but by working together with each other.

Yes, the positive thing is just how much power you actually have in your own hands. I like the term “conscious lifestyle” much more. You can also eat a bar of chocolate once …

… or drink a bottle of wine once, Marc …

… or a bottle of wine once for breakfast …

(both smile)