Continued analysis...
Page 54: ‘Over its long, rich and varied history, the architecture of health has been a monument ot the gods, a monument to God and, ultimately, a monument to science. What is has rarely been is a monument to mankind. From the temples of the ancient and the classical worlds, through the picturesque devotional structure of the medieval era to the civic urbanism of the Renaissance and the powerful monuments to empirical science of the Enlightenment, health was positioned at the heart of the city.’
The idea of health-giving architecture upheld great importance during the Renaissance. In an era with less technical abilities than our modern day building techniques - how did they achieve this? Is there great methodology or technique that the need for flash, modern buildings have overshadowed and buried? Page 54: ‘Throughout its history its physical structures have changed in function, appearance, prominence and location within or outside the walls, but the hospitals and their predecessors remained pivotal architectural elements of the city. Their scale, grandeur, decoration or sheer presence became a cipher for the mercy and charity of the metropolis, the outward sign of inner goodness. Page 54: ‘During the modern era, though, the hospital became more machine than monument, a stripped-down, functional series of boxes accommodating the increasingly complex technical apparatus for prolonging life. Architecture flatlined.
An insightful review of how our modern-day architecture has been built simply to adapt to an era full of architectural competition, mass-construction to house and care for an ever-growing population. Architecture is built for functional, physical purpose, rather than in-depth thought as to how the architecture will affect us mentally and psychologically. Page 54: ‘The result is that we spend more of our medically extended lives is hospitals, as our most joyful and traumatic moments, from childbirth to death, are spent in hospital rather than home, the buildings in which we find ourselves are devoid of cuture, stripped of aesthetic and seemingly any architectural depth or symbolism. These buildings constitute our entrances to and our exits from the physical world, yet at the exact moments we are most in need of relief, meaning and spiritual uplift, we find ourselves surrounded by the bleak expression of hygiene and efficiency which characterises the modern hospital – buildings planned on grids laid out to accommodate the most efficient distribution of fluorescent lighting. [Maggie’s Centres in comparison…] Page 54: ‘They are free to concentrate on the individual and the social. This puts them, it is true, in a privileged position, able to be freer, more expressive. Nevertheless, the relationship the centres enjoy with their host hospitals is intriguing; the suggestion is that architecture is in itself a mode of treatment, a contributory factor to the healing process. [HISTORY OF HOSPITALS] Page 55/56: ‘For the Greeks, temples dedicated to the god of healing, Asklepios, son of Apollo, housed priest-physicians and developed into something between a sanatorium and a hospital. The idea of ‘holistic’ treatment may have become a contemporary cliché, but to the Greeks that is truly what these temple complexes were. The most famous, Epidaurous … is a wonderful collection of buildings set against a dramatic landscape.
Linking back to the Maggies Centre design and methodology - structures are set in and amongst their surrounding landscape. Page 56: ‘At the heart of the cure, though, was sleep. The Abaton was a temple surrounded by a loggia in which patients spent a few nights in ‘temple sleep’, a process which presages a number of what we think of as modern practices. This sleep was when dreams would come from the gods, allowing healing. Oddly close to Freud’s analysis of dreams and foreshadowing the ideas of a sanatorium in which rest, fresh air and scenery make up a set against which we can be cured.’ Page 56: ‘This forerunner to our own hospital could hardly be more different in its architecture. At Epidauros the cure is cultural, spiritual, topographical and medicinal. On entering the complex, the patients were put on strict diets, anointed in oils and bathed in spring waters … The backdrop to the drama was the landscape, and the patient was always made aware of where they were, of their physical situation beneath the skies, within the world, in the cosmos – a word which both means order and beauty in Greek.
The thought process being to ensure the user feels in control of their own body and mind, with no manipulation of their spatial awareness. The user always feels connected and understands where they are. Linking back to a kennel setting, dogs are normally succumb to a dark, loud space wihtin four caged walls, with no idea of where they are, who it is about to walk past. Page 56: ‘This geomancy which was clearly so critical to the ancients – the attribution of characteristics to site and sitting (which survives in the Chinese tradition as Feng Shui) has entirely disappeared from our culture. Even if it may have been resurrected in the mountain sanatoria of the early twentieth century, it is rarely considered in the building of a modern hospital. Perhaps in this, Maggie’s Centres each attempting to acknowledge its setting and augment it in a landscape of its own.’ Page 57: ‘It was the voracious intellectuals of Islam who took and translated the writing and practices of the Greeks and Romans …the patients were separated according to illness , there was a large pharmacy and each department had its own fountain supplying fresh water … Patients who had difficulty sleeping were soothed by music played gently in the courtyards and by storytellers.’
This statement highlights the importance of not being naive when it comes to healing. There is no 'set' method of rehabilitation or healing, it relies solely on the individual, how they react to things, what is the best for their own recovery and needs. Page 57: [Regarding Islamic Architecture] ‘With their arcaded courtyards, celestial domes and trickling fountains these were houses of healing for both body and soul.’ Page 60: [Regarding Renaissance hospital] ‘The loggia later became a kind of leitmotif for the Renaissance hospital, an architectural device which mediated between the public and the private and which announced a building which was both part of the public and civic realm yet demanded a degree of separation’.
This structurally relates back to the previous analysis. While some patients may crave a social setting to enable them to recover, others may prefer a quiet, contemplation space. Page 61: ‘The Hospital Real at Santiago de Compostela (1501-11), with its plan based around a chapel at the centre and a series of four courtyard, was also inspired by Filarate’s building. Here the architect introduces an interstitial space between the rooms and the courtyards in the form of a broad corridor (analogous to a cloister) which becomes a secondary public space, a buffer between indoors and out and a zone which mediates between the privacy and the silence of the hospital rooms and the activity of the public realm. It is here that patients mingled with visitors’. [CONTEMPORARY HOSPITALS] Page 81: ‘More organic still is one of the most astonishing hospital buildings of the last century, the Kaedi Regional Hospital in Mauritania, 1989. Bland, white functionalism is so much the default language for hospital architecture that this building startles in its ambition to adopt the local language of brick vaults and dome … the building consists of a series of clusters of domed spaces linked by vaulted corridors, each lit by small openings which keep out the harsh desert sun while creating delightful and complex patterns of light and shade.’
![Page 81 - Rehab Basel [contemporary hospitals] 4_edited.JPG](https://static.wixstatic.com/media/028c66_bc9b9b47842f489d9db2d18d3fe3f0fc.jpg/v1/fill/w_582,h_409,al_c,q_80,enc_auto/028c66_bc9b9b47842f489d9db2d18d3fe3f0fc.jpg)
REHAB Basel - Herzog de Meuron [photograph], Page 81.
Page 81: ‘Among the most outstanding of the more conventional recent examples of healthcare is Herzog de Meuron’s REHAB Basel, a privately run residential centre for newly disabled patients suffering from spinal-chord or brain injuries.’ Page 82: ‘Courtyards, decks, grassed roofs and gardens provide a varied landscape of external spaces for people trapped in their newly immobile bodies. Perspex domes individual rooms and over the pool give patients otherwise confined to a horizontal view of the clouds and stars. A restrained material palette of timber and glass nevertheless manages to produce a relaxed architectural richness which is a million miles from the traditional images of the hygienic whiteness of the clinic.’
Page 82: ‘Gpy arquitecto’s extraordinary Health Centre in Ravelo on the island of Tenerife is surely one of the most beautiful buildings of any type. Taking full advantage of its dramatic setting in the mountainous landscape to one side and the city to the other … opens itself out to the views and the sky in a manner completely counter to local traditions which have tended to favour inward facing courtyards and blank white exterior walls. Here the concrete frame is left open to the views while the interior is encased in timber to create a warmer, more humane feel. It is treated as robust box and luxurious lining … it is building as window and each space is enriched by light and landscape.’
Gpy arquitecto's Health Centre in Ravelo, Tenerife [photograph]. Page 82.
Page 82: ‘Sou Fujimoto’s treatment centre for mentally disturbed children in Hokkaido resembles an archetypal Mediterranean hill town, the kind of seemingly random and organic cluster of white boxes … This mini-city consists of a series of interlinked corridors treated as urban spaces, rooms appearing as indoor houses, and a light, bright serenity born of that unique clash of Zen and modernism.’ Page 82/83: ‘Nakasa and Partners’ Inada Hospital in Wakayama … Architecton’s gravity-defying cantilevered section containing the ‘K-Clinic’ suspended over a reflecting pool is among the strangest of any recent buildings, let alone healthcare facilities. A sculptural presence in the townscape, a striking pavilion, it looks unreal, an extruded, blind box section yet the timber-lined interior is warm and bright, lit from the ends and via meaningfully circular skylights pierced into the deep fabric of the roof at an eccentric angle.’ Page 83: ‘the Japanese are said to feel more comfortable if their medical buildings look clinical and efficient, like a machine for health, whereas Westerners tend to favour buildings which, at least to some extent, disguise the most functionalist aspects of their function.’ Page 83/84: ‘A handful of London architects have recently achieved very fine small healthcare buildings …Buschow Henley have developed a sophisticated and coherent architectural language using warm, rich materials and generous public spaces to create extremely elegant buildings which are bold and clear in intent and function.’ Page 85: ‘Guy Greenfield Architects achieved something extraordinary with their Hammersmith Doctor’s Surgery … using a series of shells to create a façade evoking some kind of white armadillo, the building shields its function, breaks open just enough to illuminate a generous curving corridor and envelops a bright, friendly building’. Page 86: IMAGE. ‘Childrens’ Hospice in Balloch’, Scotland, by Gareth Hoskins Architects. An intimate scheme dealing with the most difficult briefs, Hoskins’ building is not mawkish or overly childish, instead treating children and families to a mature, elegant and unpretentious environment. Page 86: ‘The Royal Alexandra Children’s Hospital in Brighton (BDP) with its nautical streamlining and curving corners and its provision of each room with a sea view’. Page 87: ‘Hopkins’ Evelina Hospital … does highlight one persistent flaw in contemporary hospital design. The building, with its arcing vault of glass, creates an atrium which, while visually arresting from both outside and in and while also making maximum use of daylight and extremely fine views, veers towards the tropes of corporate architecture … The contemporary office building is too often seen as a model; its heavy serving repetitive floorplates, its blend of public and private space and its intention to resent a clean and coherent vision to the world outside and a pleasant working environment on the inside do seem to present a similar paradigm …If architects attempt to follow a similar template for healthcare architecture they run the risk of the hospital being perceived as another corporate outpost.’ Page 88: ‘I have, even today, heard doctors argue that to make hospitals too comfortable is a mistake: patients might not want to go home. This enduring idea of the hospital as a place of puritanical purging, of just the right amount of aesthetic deprivation, is understandable in that it discourages dependence.’
On the contrary, this particular notion is also intriguing to consider. Even though you may design with the greatest intention to implement calm and security, you need to ensure the purpose of the facility is put first. Like in the context of my project, the purpose is not to provide a forever home - but a facility that effectively physcologically heals in order to prepare them to transition to a forever home. Users must not develop such a dependence and reliability to a place that they cannot bare to part. Page 89: ‘The one of the key developments in modern hospital architecture was the widespread adoption of the fluorescent light, around which grids were developed and interiors planned, is the perfect indication of quite how inhuman hospitals have become.’ Page 89: ‘If the hospital now needs to ‘attract’ patients, the argument is that it should become less like a hospital, which by inference is a place nobody actually wants to go’.
(Heathcote E. and Jencks, C., 2010. The Architecture Of Hope' - Maggies Cancer Caring Centres. Frances Lincoln.)