Hospitals Are Toxic

by Allan Hamilton

There are two kinds of buildings guaranteed to sap the human spirit: prisons and hospitals. These are buildings where, as you pass through the doors, your guts tighten into a knot. Your whole body instinctively screams: Get out of here! Run! These edifices emanate toxic, destructive energy. Yet the stated purpose of one type of institution is to contain prisoners for the welfare of the public but also to rehabilitate those who are susceptible, and, hopefully, may seek to redeem themselves when they are re-introduced into society. The purpose of the second kind is to heal people, to reassure them their ailments will be addressed, and their bodies attended to with loving care. Yet, as you look at these buildings, you do not any of feel these lofty, altruistic missions enshrined in them. No, you sense a darker, menacing purpose emanating from these structures.

While in the US Army Medical Corps, I had the opportunity to lecture at Fort Leavenworth, Kansas. It is the site of a large federal prison, housing more than 1700 souls. It has a wing for inmates sentenced to death and a complex nearby where they will be executed by lethal injection. You arrive at the front entrance and pass through a series of guardhouses, that lie interspersed between rows of chain-link fences, each capped with curling waves of razor sharp concertina wire, wreathing the whole complex. The stone walls are monolithic. They rise more than forty feet high and the foundations are buried more than forty feet deep in the ground. The walls seem to say it all. If the impossibility of escape were not enough, these ramparts proclaim that the rest of the world, the life outside, is inaccessible, unattainable. Not just beyond reach but beyond imagination. Worse still, is the central building itself—a long building, built out of gray granite several stories high. The front has a classically designed portico, reminding you of the power of federal authority. The structure towers over you like a cliff. There are small, slit-like windows, more like cracks in the rock. I imagined desperate knuckles there, wrapped around the bars, pressing faces towards the sunlight. You do not walk into such a building as much as you are swallowed, gulped down by it. I had the distinct feeling that if a building alone could kill a man, this was the one. There was a dreadful, predatory power to the structure, as if it stalked every soul within its grasp.

What about hospitals? No one, not even physicians, looks forward to going into the hospital. I make my living inside a medical center. But I do not get a warm and fuzzy feeling when I walk in. No, the whole complex gives off an aura of oppression, antisepsis, and demoralization. These are not structures built to greet or embrace you. No these walls are squat, square, functionally angular. Fluorescently lit. Labeled. Anonymous. Aloof. These are buildings that make you feel lost. 
I pass the hospital rooms on our wards every day. The volume of ambient noise on the medical-surgical floors overwhelms me. There is a constant buzzing in the air. The hum of machines. The murmur of the hive. Patients wait in their beds, dreading whatever still must be done.
No, there is no feeling of comfort or refuge in my hospital. Every night I leave the hospital, I feel this enormous sense of relief. Of having been in the belly of the beast and escaped the grip of the architectural monster for another day.
The question arises: how could a hospital’s design be improved? First, the building should convey a sense of peace and healing. A feeling should be conveyed that Nature has been allowed to infiltrate and invited to settle in. People want to bring flowers to the hospital to cheer patients, yet, there is no consideration to the creation of lush, blooming gardens in parks crisscrossed with paths for strolling. When I was sixteen, my great uncle Willy took me on a crisp, clear morning to a beautiful hill top park overlooking Zurich, Switzerland. It had several vast expanses of lawn. Uncle Willy made me take off my shoes and socks and walk barefoot through the grass, brimming with cool dew. He confided to me that he walked there two or three times a week. He tapped his heart lightly with his fingertips. “My heart soars,” he said, “every time I walk in the dew. It makes me feel like I am the first person to ever discover it. I feel like a pioneer.”
I wonder how healthful a lawn full of dew could be if it lay at the heart of a hospital. If every patient could shuffle right to its edge, slide his or her slippers off, and walk into the dew. Imagine a long row of paired slippers abandoned on one side of the path and happy, dewy feet milling about on the other. With my Uncle Willy guiding them all barefoot, like the Pied Piper.
In many hospitals, you will find an aquarium, where beautiful fish and inviting coral landscapes can be observed and admired. But this is as far as the animal kingdom is permitted to manifest itself in hospital. At my medical center, security guards patrol periodically with German Shepherd dogs. Thank goodness these canines have never sniffed out a bomb or snarled at a perpetrator, yet all day long they are stopped in the course of their rounds to be petted and greeted by patients, visitors, and staff. I am grateful the guards understand how much we can long for the touch of a warm, furry coat. The silky feel of ears, folded back in greeting.
My German grandmother believed that fresh air was essential to good health. No matter how cold it might be outside, she flung windows wide open at night to ensure “our body’s oxygen turned over.” There is something invigorating about sleeping with the clean, fresh air circulating around me at night. My hospital has only sealed windows. No opening for fresh air was ever contemplated.
What about noise pollution? All night long there are overhead pages and nurses calling out over the intercom. Telephones, monitors, and computer screens ring and ping incessantly. With the catastrophic nursing shortage, there’s virtually no hope anyone will ever answer these auditory prompts in a timely fashion. Just to ensure a patient will never get a wink of sleep, most hospitals also shove them into two bedroom suites. Think about that. If I wanted you to get a good night’s sleep, would I make you bunk with a complete stranger, moaning and groaning with his own woes? Then there’s the disruption of circadian rhythm. Although hospitals try to turn off the lights, there is almost incessant artificial light streaming in from hallways and work areas.
There is hardly a corner where families can sit in privacy. Nor are there sitting areas where physicians can have confidential conversations with family members. Some hospitals have even decided to do away with chapel for prayer and meditation. I am struck by the incredible difference in design and feel between a spa and a hospital. Where would you rather recover from an illness or surgery?
It is not an accident that hospitals appear oppressive or that prisons evoke despair. Buildings advertise their goals because architecture speaks of purpose. These are edifices designed to remove freedom and deny individuality. Our souls feel a direct peril when we see a jail or a medical center. They are telling us to save ourselves.