Baltimore — A new $1.1 billion addition to Johns Hopkins Hospital is an impressive building, not because it’s entirely beautiful, but because it is enormous and because, like all state-of-the-art hospitals, it contains an astonishing internal complexity. Its rounded facade of colored glass juts out over the sidewalk, making the building on Orleans Street a prominent new landmark in East Baltimore. With 1.6 million square feet, a parking garage, two pedestrian bridges over a major thoroughfare and a football-field-size front entrance with gardens, the addition creates a new “front door” for the prestigious medical center.
If, as Corbusier once said, a house is “a machine for living,” a hospital is a machine for healing and dying. One enters hoping for the former, but the reality of the latter lurks in the mind, even if you are visiting a hospital in rude good health. Hospitals remind us not only of our mortality but our collective dead, family and friends who entered and never left, or who left to spend a few final weeks beyond the reach of hope or revival.
The modern hospital evolved from its origins in the charitable care offered by religious organizations centuries ago. Then, the likely plan centered on a courtyard, with a prominent chapel or church. The modernist hospital of the past century, with its rectangular forms and glistening white walls, projected cleanliness and scientific confidence. Today, a new typology has taken root, and hospitals often seem like a hotel wrapped around a high-tech factory.
The new facility, designed by Perkins + Will, divides neatly into “front” and “back” of house spaces, the former more finely finished and the later clearly functional. Perkins + Will specializes in large-scale, highly complex projects, with a portfolio of airports, transit hubs, hospitals and research centers. The new Johns Hopkins center is typical of the firm’s monumentally scaled work.
Built on an eight-story base, it features two 12-story towers — one primarily devoted to children, the other to adults. Patients and visitors will encounter first a large entrance court, with manicured gardens and a rectangular water feature, then move into one of two atrium spaces at the base of each tower. Public elevators, corridors and waiting rooms are designed to soothe — as much as certain colors and natural light can allay anxiety.
But the “back” of house space is only one double-door away, where bumpers on the walls at waist level (to repel errant gurneys), institutional lighting and low drop-ceilings proclaim a no-nonsense institutional purpose.
The basic shape of the building reflects several of the essential dichotomies of health care: It is driven by compassion and the bottom line, by sensitivity to the sick and the practical need of doctors to do their work in basic, mechanical ways. One senses the same architectural dilemma that would confront a designer trying to create an upscale auto service center: No matter how you gussy up the waiting room and offices, ultimately the space must be congenial for fixing cars, which is a messy business.