The ego and expertise of the architect are both embodied in the University of Chicago Medical Center’s newest hospital, the Center for Care and Discovery, designed by Rafael Vinoly Architects. The enormous hospital was Vinoly’s idea, successfully pitched eight years ago to the UCMC as the board began to plan the renewal of Mitchell Hospital.
Here, on the northeastern corner of the medical campus, architecture’s ambition for the skies has been tempered – but not diminished – by the demands of medical use. At 1.2 million square feet, the new hospital is over a quarter the size of the Willis Tower. It is ten stories tall, but because of large space between floors reserved for medical utilities and the two-story tall HVAC unit and helipad atop the building, it looks much taller. More shoebox than obelisk, it fills two full city blocks and spans Maryland Avenue. The form of the building is intended to reduce elevator trips, which are cumbersome for patients in wheelchairs and gurneys and waste time for doctors and nurses. Compared with the courtyard design of the old Mitchell Hospital which the new Center is replacing, the large floor plates are meant to yield efficiencies of scale.
Because of its scale, fitting the building into its context is a challenge. Overlapping metal louvers banding the facade on the lower floors are designed to cast shadows that provide visual relief from the sheer vertical rise. Likewise, bands of color – painted metal panels – and variations in the setbacks at different levels are designed to provide variety on the facade and reduce the mass of the building (Vinoly’s materials – sans brightly colored metal plates – recall his 2005 building for the Booth School of business anchoring the southwestern corner of the University of Chicago campus). The result is a building that is enormous without being overbearing. Remarkably, Vinoly has succeeded in integrating the building gracefully into the campus landscape.
Functionally, Vinoly has divided the building along a vertical axis. Joseph Cliggott, project manager at Rafael Vinoly Architects, says, “The exterior expression of the building conveys the 3 primary functions of the hospital: the lower floors, where all the clinical procedures occur – the ‘Factory,’ as Rafael would describe it, the upper floors where inpatients recover from procedures – the ‘Home’ in Rafael’s words – and the Level 7 in between, or the ‘Garden’.”
A hospital is demanding architecturally because of the intense physical and emotional demands of its users. It is in the vast lobby on the seventh floor – the ‘Garden’ – that Vinoly’s care for these emotional demands shows itself.
Even in the middle of the day, the lobby is suffused in twilight. The ceiling is veneered in lengths of dark cherry between which recessed lights sparkle at uneven intervals. Like stars, the lights emphasize darkness, rather than illuminate space. Far away, across the glossy white floor, floor-to-ceiling windows an uninterrupted view of the South Side. Set above this bright strip of windows, capping it, the ceiling pushes down, compressing the space. It is this overhanging presence which saves the Sky Lounge from being a cavern and reduces it to a more personal scale.
This quiet twilight is a place where one can be publicly and unabashedly alone. Leading by example, a player piano set off to the side plays old standards to itself. In the middle of the room, in the heart of the twilight, one woman has folded herself onto a small couch and is sleeping uncomfortably. Along the windows, where it’s brighter, more active patterns of use prevail: some people are working alone, while others talk quietly. Vinoly has succeeded here in subtly using light, shadow, and color to divide the enormous room.
At the Southwestern corner of the room is a small sign indicating “Chapel.” The sign marks an alcove lined with curving walls of russet wood. It’s a dead end at first sight. The entrance, hidden in the wall, reveals itself only under careful investigation. The door opens smoothly into an elliptical room, lit from above with clerestory windows. All hard surfaces, it feels like being at the bottom of an empty seashell. The space is sufficiently isolated to provide room for reflection, but too cold to give comfort.
In the cafeteria, at the east end of the building, a different dynamic presides. Like the Sky Lounge, the cafeteria is vast. The ceiling and the floor are both white, accented by bright royal blue and orange. Here, light is welcomed in, rather than held at arm’s length. The wall on the north end of the cafeteria is faced in cherry; it marks the entrance to the massive boardroom, also paneled in cherry. The wood veneer continues past the windows and wraps around the exterior facade, blurring the distinction between out and in.
On the upper floors, patient rooms are placed around the perimeter of the building to take advantage of expansive views, shown by Roger S. Ulrich and other pioneers of evidence-based hospital design to improve patient recovery. All patient rooms are single-occupancy for privacy and quiet, likewise shown to improve recovery and reduce time spent in the hospital. These design decisions reflect a focus on patient experiences and outcomes that has been growing in American healthcare for the past twenty years.
Like the Center for Care and Discovery, hospitals across the country have long been increasing the ratio of operating spaces to patient rooms and using architecture to reduce inpatient stays. There are strong financial and medical reasons for doing so. Especially in this hospital, financed by $500 million dollars of debt – presumably secured against future patient revenues – this focus on the patient is a wise decision.
The Center for Care and Discovery will nestle comfortably and unremarkably into the skyline of the South Side; few will remember it as a distinctive piece of architecture. But for many, it will be a place of healing and of comfort, and, if it accomplishes this, then it will be a job well done.
Cover image by Tom Rossiter.