You're in pain, perhaps confronting your own mortality and give control of your wellbeing to someone else, a stranger, other powers of technology or medicine or some other unknown.
"The history of hospitals is therefore one of the construction of systems of control and imprisonment, confinement and isolation, dissolved through the good offices of architects into fragments, structures that try to look like someplace other than what they are."(1)There is a constant tension between the tendency of hospitals to expand like some cancerous growth into giant machines for healthcare or to dissolve into anonymous components throughout the city.
The history of the hospital as a building type
The hospital has always been rather difficult to define as a building type possibly because its something we'd rather not see or know about. Even during the 18th century at the height of attempts to create a clear type, there was criticism of any architecture that tried to make the hospital 'look nobler than it really was."(2) Historically, hospitals were places to confine and control the needy and the dangerous - up until the age of Enlightenment, whether the residents were patients or paupers was irrelevant. Anyone who was not useful, was inefficient, or was not a good citizen was best isolated in hospices, almshouses, orphanages or hospitals. Both the rich and peasants were sick and died at home, not hospital. The hospitals were similar in appearance and function to places such as the military camp, monastry, cloister, orphanage or poorhouse. They were square or rectangular structures with a central open courtyard and focal points comprised of temples or chapels (these places of faith and religion were later replaced by operating theatres...religion versus science). Hospitals were (and still are) low and anonymous, with an inward focus, hiding their function and character. The ideal versions of this building type were the radial plan hospital such as that proposed by Bernard and Charles-Phillippe Coqueau after the Hotel-Dieu fire.To counter these designs, in 1694 Christopher Wren designed the Greenwich Naval Hospital as a series of freestanding pavilions, a design with Classical roots - Ancient Greek examples of this are seen in the ascelpion which was a collection of individual buildings grouped around a temple to the god of medicine. Wards were originally small structures where the family and patient could sleep. There were separate buildings for different functions and the hospital was thus seen as a larger version of the family home, in a complex seen as an antidote to the city. This pavilion model of the hospital was lost as technology became more prominent and promoted a centralised arrangement. However, the pavilion model continued to be used for places of long term care and convalescence such as asylums, leper colonies, tuberculosis santariums and places for the elderly. A nice example of this is Otto Wagner's 1907 Steinhof Psychiatric Hospital where the architecture 'tried to reconnect its patients with both society and nature through an elaborate decorative scheme.' This is discussed by Leslie Topp in Art Bulletin.
[See also article link by Leslie Topp on the emergence of the asylum mortuary as an architectural challenge during the late 19th/early 20th century, which includes analysis of Otto Wagner's approach.]
Summarised from:
Bestky, Aaron. "Framing the Hospital: the Failure of Architecture in the Realm of Medicine." In The Architecture of Hospitals, edited by Cor Wagenaar, 68-75, Rotterdam: NAi Publishing, 2006.
(1) Aaron Bestky, "Framing the Hospital: the Failure of Architecture in the Realm of Medicine." In The Architecture of Hospitals, ed. Cor Wagenaar (Rotterdam: NAi Publishing, 2006), 68.
(2) Foucault, Michael. The Birth of the Clinic : an Archaeology of Medical Perception. Translated by A. M. Sheridan Smith. New York : Vintage Books, 1994. Also at http://solomon.soth.alexanderstreet.com.ezproxy.auckland.ac.nz/cgi-bin/asp/philo/soth/documentidx.pl?sourceid=S10021883
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