Why are so many hospitals so ugly?

ACXT Amarante Hospital Portugal

Why are so many hospitals so ugly?  I wonder this all time. I think about it not only because I walk through a hospital every day (I work in a physiology lab attached to a teaching hospital), and not only because I’ll probably spend my career working inside of a hospital, but I’ve also been thinking about it lately because I, along with almost everyone else, have had the displeasure of visiting hospitalized family members. It’s not fun. What’s more, hospitals are dangerous places where almost 80,000 people die each year from infections they acquire inside the mazes of beige drywall, and money that could be used for environmental improvements often goes other places.

There’s no way I can properly answer the question, but I have a few opinionated guesses and a few examples of projects that are trying their best to create quality spaces for patients and their families. My best guess is that hospital construction is driven by conservative building committees and that the overall environment of a hospital suffers as the building grows from a single building to an addition on an addition on an addition. Of course, there are examples of hospitals with a conservative approach to architectural expression that still are nice places for patients and their families. Take, for instance, Celebration Health designed by Robert Stern in Celebration, Fl. Celebration is the town built by Disney where everything is nice, and even if I personally dislike the town’s abundant pastiche, I understand that some folks will like a hospital that vaguely resembles the massing of LA’s Union Station.

ACXT Amarante Hospital Portugal

And then there are hospitals I think look interesting, but might look too severe to other people. Like the one above, a recently completed hospital in Portugal that doesn’t even appear to have patients inside of it yet. Or this hospital in Rwanda that is helped by both its setting and photographer. We have featured a few healthcare facilities in the past, but it doesn’t get around the problem that (to paraphrase Joshua Prince-Ramus) “no matter what, half the people will hate it.” Still, there are some qualities that we can all agree on. Like indoor air quality and not wanting to contract a life-threatening infection when we have to stay in the hospital ourselves or with a loved one.

ACXT Amarante Hospital Portugal

It’s complicated, and in most ways architects only contribute to hospitals for a fraction of their lifespan before they’re ever even used.  But their fingerprints on the function of a hospital lasts much longer. Architects can specify amenities, but not how well those amenities are maintained or how they might translate into qualities for the the folks that end up using hospitals. It’s not just a problem of taste, financial resources, available space and priorities but a cumbersome and murky quandary with these and many other factors competing for answers. As much as I can complain about the abysmal fold-out sleeping chairs I’ve been resigned to using in many hospital rooms, these ugly buildings bring millions and millions of people back to health each year. They are spaces that enable some incredible things to happen, even if they’re almost guaranteed to be clinically dull. I just wish they weren’t so ugly.

March 8, 2013 / By