About 10 years ago, America was introduced to feng shui. We didn't know if it would be merely a fad or if this ancient practice would have actual relevance for us. During the past few years, especially since Y2K and 9/11, people seem to have become more receptive to new ideas. They are seeking meaning to the things they do and the spaces they design.

Many people have accepted the fact that the environment really does affect us, and they are now more open to understanding how the invisible energies, known as ch'i, work within our lives. We don't question the ebb and flow of the tide or the changing of the seasons, and now many of us want to delve deeper into these invisible energies that can't be seen or touched. Feng shui is the study of these energies in the environment. Even those who are skeptical might appreciate some exposure to its precepts.

Feng shui has been called a combination of art, science, and philosophy. It originated at least 4,000 years ago in China, where the emperors were thought to be the “sons of the heaven” and vested with supreme powers. They lived in palaces that were designed and built in the most ornate fashion on sites with good feng shui; they were both scenic and serene. According to the principles of feng shui, creating harmony and balance between the influences of man and the forces of nature played an important role in creating the environments of power inhabited by the imperial rulers.

Feng shui literally means “wind” and “water,” two aspects of ch'i that the Chinese have long believed to circulate through the body and the earth. Emperors and rural people alike studied patterns of rivers and lakes, directions of the winds, and elevations of terrain to determine the presence and pathways of the ch'i flow. Their buildings and palaces were positioned to capture the most auspicious energies and bring protection and fortune to their occupants. For example, siting a building, even today, on the bottom third of a mountain or large hill, having water in front of (not behind) the building, and having some form of protection (trees or small hills) on both sides is said to be the “armchair” position, bringing auspicious energies to the occupants.

Feng shui involves the understanding of:

  • the Confucian classics, such as the Yijing or I-Ching (Book of Changes);

  • the meaning of yin and yang, or the theory of negative and positive energy, or ch'i;

  • the application of the five elements (figure 1);

  • the knowledge of magnetism and the unique energies of each compass direction;

  • ecology or, in today's terms, protecting our environment through methods of sustainable/green design;

  • adaptations of building and interior to feng shui principles; and

  • landscape design, including the location of the building on the site, based on feng shui principles.

The five elements are used in Chinese medicine, acupuncture, and feng shui

The basic concepts, as applied to healthcare design, include:

  • balancing yin and yang

  • balancing the five elements

  • designing a space to avoid sha ch'i (negative energy)

Balancing yin and yang. Because of the very nature of a hospital, it is a yin place. People are there because they are ill, and that is a yin experience. On the other hand, healthcare providers are generally healthy but often quite anxious-the yang side of the energy spectrum. Balancing this energy means bringing yang energy to the patients and yin energy to the staff.

How this is applied can be found in the example of the gamma-knife suite at a large urban hospital. As most readers know, a gamma knife-used for treating advanced brain tumors-is an intimidating piece of equipment, a 75-pound metal half-dome placed on the patient's head for several hours during and immediately after the procedure. The facility's gamma-knife room was located at the southern end of the campus and, according to feng shui, the south represents fire energy, deemed much too potent for this area. Therefore, earth-tone colors were used for this room because feng shui says earth calms fire. Incidentally, the south of any building represents fame/reputation in feng shui; thus, locating a new program needing publicity and recognition here will bring fire energy to the program.

References to nature can also help balance a stressful environment, according to feng shui. Natural light, interior and exterior gardens, courtyards, and access to scenic views are excellent ways to bring nature closer to patients, family, and staff.

Balancing the five elements (Figure 1). Balancing fire, earth, metal, water, and wood is essential. We know intuitively that a room with too much of the same color or surface type feels wrong in some way, and we typically balance it with other colors, textures, and shapes. Balancing it through the use of the needed element creates the type of space that “feels right.” For example, if a room has too much white and gray (representing the metal element), it will feel sterile and cold. Adding items in colors representing the other elements (red for fire, earth tones for the earth element, blue for wood, and black for water-and, yes, understanding the feng shui interpretation of these colors does take some study) will make the room feel balanced.

Further, each person has his or her own natal element (one of the five elements), and his/her personal spaces should be designed to complement and nourish his/her specific needs. In a large building, such as a hospital, this often isn't possible, either in public spaces or in patient rooms, where the occupants change every few days or weeks. However, one East Coast hospital will be testing a new birthing room, based on feng shui concepts, that can be personalized to each patient as she is admitted. Patients choosing to participate in the study will have opportunities to select items such as art, vases, bedspreads, and tackable display surfaces, which will nourish their energy, based on the elements in feng shui as they relate to a patient's specific date and time of birth. The location of the bed will also be adjustable in order to suit the patient's “best direction,” an important aspect of feng shui.

Designing a space to avoid sha ch'i (negative energy). Bringing sheng ch'i, or harmony, to a design requires careful planning. The orientation of the building, the direction of flow of nearby water, the orientation of the sun, and the placement of rooms within the space must all be taken into consideration. There are dozens of feng shui no-no's when it comes to design, including:

  • square corners and columns in certain situations

  • exposed overhead beams

  • buildings (or offices) located at a “T” intersection of roads or corridors

  • water behind a home or building (except in certain circumstances)

  • long, straight corridors or roads

  • stairs located directly in front of the main door

  • open stair treads

  • straight sidewalks pointing directly at the front door

  • irregularly shaped buildings and buildings with missing corners

Other basic feng shui guidelines include:

  • Avoidance of sharp corners on columns and furniture, called “poison arrows.” This is especially important for patient rooms, which often have the edges of square columns protruding into the room.

  • Bringing nature inside as much as possible. Studies have shown that even a small image of a beautiful scene can be a natural tranquilizer. Real plants, fountains, and artwork depicting nature scenes can contribute to a healing environment. While the healing power of nature has been known throughout the ages, recent studies have shown that our positive (or biophilic) response to scenes of nature can help reduce stress and ease pain.

  • Using natural products and avoiding synthetics that emit toxic fumes over long periods of time. These are today's methods of observing the ancient Taoist concepts of respecting and preserving our world. For example, very ill patients should not be exposed to some types of recently installed synthetic carpeting, although vendors are making progress in this area.

  • Avoiding clutter. This is especially difficult in overcrowded hospitals, but any form of clutter (paper, equipment, etc.) becomes a subconscious weight bearing upon those around it. According to feng shui precepts, clutter must be cleared away to allow new energy and new opportunities to come forth.

  • Lighting can also be used to bring positive energy to an otherwise dark space (Figure 2).

The use of lighting to increase positive ch'i energy can be seen in the before (left) and after (above) photos of a hospital corridor

A related aspect-that of applying the appropriate chakra color for the specific part of the body being treated-is yet another level of feng shui design (Figure 3). For example, since the heart chakra is green, this color can be used in a cardiac catheterization lab or other cardiac-related department to bring healing energy for patients recovering from heart-related procedures. Blue can be used in an ENT clinic to bring healing energy to the 5th chakra, which centers on the mouth and throat areas.

When all seven chakras are spinning in harmony, at the same speed, the system runs smoothly, as a single mechanism

In summary, looking at a building through feng shui eyes includes assessing the following:

  • shape, position, and orientation of the building and neighboring buildings;

  • location of nearby roads, rivers, lakes, or hills;

  • direction the building faces;

  • materials used for construction;

  • indentations and extensions;

  • doors, especially entrance doors;

  • location of stairs and elevators;

  • location of the CEO's office;

  • protruding corners, columns, or furniture;

  • locations of toilets;

  • colors, patterns, and materials; and

  • clutter and cleanliness.

As a designer and student of this process, I believe that the healing aspects of feng shui can be woven into the planning, design, and interior design of any healthcare project to produce a space that is more harmonious, comfortable, and supportive for all who enter. HD

Barbara A. Dellinger, IIDA, is a certified feng shui practitioner and a principal with Oudens & Knoop Architects in Chevy Chase, Maryland. She has been designing healthcare interiors for 15 years.

For further information, phone (301) 718-0080, e-mail b-dellinger@okarch.com, or visit http://www.okarch.com.

Healthcare Design 2003 May;3(2):33-36