Hospitals
Authors: Knoblauch Joy , Honarmand Ebrahimi Sara 
Published: March 2023

As a building and as an institution, each hospital reflects the values and priorities of the society in which it resides. As a place of healing, the design responds to theories of faith, medicine, and technology. As a resource-intensive instrument, each contemporary hospital responds to funding structures, whether publicly funded, charitably funded, operating as a business, or some mix of all three. From their origins within religious institutions to contemporary flagships of innovative technology, hospitals have changed a lot, and many different types of hospitals continue to exist in the present. Religious ties remain strong, and the distance between a small country hospital and an urban university medical center is measurable in much more than miles. It should be acknowledged that the idea of a building “typology” is always already flawed, being itself a problematic notion with roots in colonial and racial ordering systems based in quasi-scientific thinking. So while it should not be taken as essential, the cultural symbol of “the hospital” does still achieve prominence in many eras, providing a window into the life and death of a society. In the twentieth and twenty-first centuries, these buildings and institutions retain an innocence and association with faith in technology that often cloaks deeper, more complex, and deadlier truths. Peeling back that cloak may not be easy for those with a weak stomach (quite literally, in that many stories and images bring pain, sickness, and death to mind), yet the study of hospitals has much to offer scholars of architecture, culture, technology, religion, risk, and the limits of human bodies. There are two broad sets of literature on hospital architecture. The first includes those written by architects, physicians, religious administrators, nurses, and patients. These works provide practical guidance, sometimes offer a historical overview, and often include insightful comments about bodily experiences in space that may be overlooked in literature on other buildings. Curtains, drains, and the sounds of wheels along various flooring materials become worthy of attention and commentary because of the chronic and somewhat involuntary occupation of the buildings, as well as the need to worry about transmission of diseases, which can require the management of each small gesture. The human occupation and the social element are no less crucial in these often insular institutions where close physical work with high stakes happens across race, class, and gender lines. The spaces are undeniably physical, emotional, and authoritarian. The patients, families, and staff in a hospital confront boredom and crisis, again and again. In particular, the field of hospital administration reveals important discussions about space, cleaning, and the many instruments devised by 20th-century humans to manipulate bodies into position for surgery, bathing, or mobility. The second set includes literature that provides historical analysis of hospital architecture. Appearing initially in the 1980s, this topic is now becoming a serious preoccupation of architectural history. Working from drawings and photographs, this literature shows that hospital history is not only medical, cultural, political, and religious, but also architectural. The focus has predominantly been on hospitals built in Europe and North America over the last forty years, but there are signs that this is now changing.