Project Summary

Client: Stanford University Medical Center

Architecture: BTA, Inc.

Civil Engineering: Brian-Kangas-Foulk (BKF) Engineers

Structural Engineering: KPFF Engineers

Mechanical/Plumbing/Electrical: Affiliated Engineers W, Inc.

Landscape Design: Pamela Burton Company

Photography: Bob Swanson Images

Completed: March 2004

Total Building Area (sq. ft.): 220,000

Total Construction Cost: $85,000,000

Cost/Sq. Ft.: $386

Twelve years in the making, Stanford University’s new cancer center had one purpose only: to make life easier for patients with cancer. Achieving that good-hearted, simple-sounding goal tested the ingenuity, professional skills, and patience of architects, administrators, and constructors far beyond normal requirements. The extraordinary efforts entailed in securing a bay of seven linear accelerators are detailed in a companion article, “Constructing a State-of-the-Art Cancer Center,” p. 52 in this issue. But the rest of the building posed its own challenges, as discussed in the following comments by Michael Bobrow, principal of Design/Planning at BTA, Inc. (Bobrow/Thomas & Associates Architects) and Lou Saksen, vice-president of General Services and Radiology, Stanford University Medical Center—by Bobrow’s description, “the driving force of the project.”

Beginnings

Saksen: “Stanford University has long been famous for its cancer services and innovation. The first linear accelerator, for instance, was developed here. But services—chemotherapy, radiation, and imaging—were scattered all over the medical center, which was not what one might expect from the patient’s standpoint. We did our first feasibility study of a plan to pull all this together in 1992. The California entitlement process is a lengthy one. We started in earnest by hiring an architect and developing an environmental impact statement in 1995. We completed this in 2000, were certified in June 2001, began construction that September, and opened this March. We went through numerous changes in top management at the university and the medical center, but the basic design was so solid it went virtually unchanged through the entire process.”

Bobrow: “Stanford invited us in 1995 to participate in an international design competition, and we were one of three firms that were short-listed. Each design team was given an honorarium to work with all the users of the cancer center—doctors, nurses, administrative staff, and community representatives, including users, past users, and their relatives—to develop concepts. It was a process I hadn’t been through in 35 years as an architect, and it was a wonderful way to develop an understanding of the users’ needs and priorities and to develop excellent working relationships. Our designs were presented to the university president, chairman of the board, and trustees, and our team was selected.

“Our design was based on three concepts: (1) to be as supportive of patients with cancer as possible, (2) to be as flexible as possible—and, over the eight years of the building’s inception the technological aspects of cancer care changed radically—and, (3) to integrate the new building with the Stanford University campus and neighboring hospitals.”

Let There Be Light

Bobrow: “The design turns the building ‘inside out.’ All the public areas are on the outside of the floor plan, including bay windows for patients and families, and all the technical spaces are on the inside. It’s all designed around a central atrium that allows the inside spaces to be lit from both the atrium side and the outside windows. In effect, we’ve built the building in a garden. The Stanford campus has a long history of providing gardens in public spaces supported by philanthropy.”

Saksen: “The building pulls this exterior into the inside. These patients are very ill, and we wanted to make sure they had views to the outside, with plenty of natural light. We also wanted these outside spaces to be quiet, a place for reflection. We have an Asian garden with a fountain and soft Japanese music playing and, at the opposite side, a bamboo garden through which pedestrians can walk to and fro through the campus without having to go through the parking deck—the original arrangement. Plenty of places are available for sitting and, as it turns out, the gardens are as helpful to families, who often have to endure patient treatment waits as long as three or four hours, as they are to patients. Meanwhile, the atrium, with its third-floor skylight over the main stairwell, allows light to come in no matter where you are in the building. Michael Bobrow, Julia Thomas, and Greg Doench at BTA were very careful to fenestrate the building so that there are no dark spots.”

Ease of Use

Bobrow: “We’ve designed this center with considerable flexibility, with as open a floor plan as possible. All the ductwork has been wrapped around the exterior, and there are ducts around the bay windows for air distribution. The rooms inside can be reconfigured conveniently. We’ve reduced the use of fluorescent lighting and used more incandescent lighting and more warm tones and wood inside to make the building feel more user-friendly.”

Saksen: “With all services located in one building, patients know that they are readily available. They can use the elevators to go from floor to floor—and many do—and easily find services that used to require considerable horizontal travel between them. Radiation Oncology is on the ground floor, the clinics are on the first floor, and infusion therapy and other procedures are on the second. In the future, ambulatory surgery services may be on the third. The third is actually the largest floor plate, extending out over the driveway to provide a porte cochere for sheltered entrance and exit.”

Tying in With Campus

Saksen: “This building had to blend into a very tight site accommodating three other major facilities: two hospitals and a 700-car parking garage. It is 220,000 square feet of new construction, and yet you wouldn’t know, just by looking at it, that it was a new building. I’m a bit biased, but I think it is the best building on campus outside the original quadrangle.”

Bobrow: “Integrating this building with its neighbors was a major design goal. As an example of how we approached this, the original medical center next door was designed in the 1950s by Edward Durrell Stone. Our southern façade presents with a series of vertical and horizontal ‘light shelves’ that create a dappling effect and appears to be a contemporary version of the Stone design.”

Final Thought

Saksen: “This was an incredibly complicated site to work with, and its challenges were resolved masterfully. It ties the medical center together—almost like the last piece of the puzzle fitting in the middle. Ultimately, this was designed from the perspective of the patient, to nurture a patient who is desperately ill. And the biggest thing I’ve noticed since we opened in March is that patients and their families smile a lot more.” HD