The integration of fine and applied art in healthcare design
Fine art has been important to man since he first began adorning his dwelling. At the Chauvet-Pont-d'Arc cave in France, Paleolithic hand stencils and stylized images of wildlife dating from 30,000 BC decorate the walls of the cave. These images describe what was important to these people and show an early desire for fine art within the living space.
The term “fine arts” came from a translation of the French term beaux-arts in 1767. It referred to arts that were “concerned with beauty or which appealed to taste,” and it encompasses visual art forms—such as painting, drawing, and sculpture and music. While Michelangelo's David or a Beethoven sonata serve no practical purpose, we can recognize how these arts enrich our existence and make our lives more pleasant.
“Applied Art” concerns objects that serve both a practical and artistic purpose. One form is architecture; however, cars, airplanes, vases, teapots, chairs, and other everyday items are also part of this category.
The integration of fine art into architecture is both ancient and cross-cultural. Greeks, Romans, Hindus, Muslims, Aztecs, Chinese, and many other civilizations incorporated fine art into their buildings. The Caryatids at the Erechtheon, from 421 BC, are sculpted female forms that also act as columns. At Chichén Itzá in Mexico, the Mayans incorporated sculptures of their gods into their temples and civic buildings. It was their inherent nature to do so, just as it is ours.
The Greek and Roman methods of architecture endured as the major styles in the West for 2,000 years. Finally, at the turn of the 19th century, the mechanization of manufacturing during the Industrial Revolution made it possible to mass-produce steel, glass, and new building materials, allowing for greater freedom in design. The profusion of architectural styles during this time included the Secessionist movement in Austria, Art Nouveau in Belgium and France, the Chicago School, and the Arts and Crafts movement. All of these new directions maintained integration with fine art. Only one school of architectural thought did not—The International School.
The International School embraced the machine age. The glass and steel that were now available allowed for taller buildings with larger windows. The resulting designs were based on the ideals of simplified forms and unadorned functionalism. Ornament was considered a crime. The architect Le Corbusier called his designs “machines for living,” representing a complete break with the past and an expression of the political times.
The International School's style has dominated architecture to this day. One simply has to open the latest architectural magazines and compare today's images with those of the Fagus Works designed by Walter Gropius in 1911. Unadorned functionalism prevails even though the relevance of the Industrial Revolution has passed. Why? Simple—it makes everyone more money. It is easier for architects to design, easier for contractors to build, and easier for owners to sell.
Consider the costs associated with designing the IBM Building in Chicago as opposed to the Tribune Tower. The IBM Building is simple and repetitive without sculpture or fine art of any kind. Minimal architecture means minimal design costs. Less design time means more money. This is a definite case of less is more. The Tribune Tower, however, is a highly sculptural Gothic-style building with complex floor plates and complex details. Contractors will often recommend cutting out these elements for budgetary reasons. Cheap, simple structures mean lower costs and add more to the bottom line, leaving little wonder why there are so many of these structures around today.
If everyone makes more money, why should we change? Because we have a deep and inherent desire to express ourselves through fine art. For 32,000 years, fine art was integrated into our structures. Our buildings tell future generations who we are. The Industrial Revolution has long passed, and as we live in the information age, we find that our tastes, needs, and political influences have changed. These changes should be reflected in our architecture.
Another question is whether the minimalist International School style is appropriate for healing environments. Recently, The Center for Health Design commissioned the Johns Hopkins School of Medicine to undertake an objective assessment of the effects of architecture and art on medical outcomes. The assessment showed that changes in environmental design do affect medical outcomes. Issues facing both patient and staff were affected, such as length of stay, reported pain and intake of pain medication, and patient satisfaction, as well as medication errors, staff turnover, and staff satisfaction. In other words, our surroundings affect us psychologically and, consequently, physically.
The hospitals and sanatoriums built in the late 19th and early 20th century had no design concept in place to take into account the psychological effects of design. Little was known about the spread of disease and the treatment of illness, and so the function of hospitals was limited. For many patients, admittance into a hospital was a last resort and a final step. Now we are creating wellness centers and integrated spas. Healthcare facilities are places of physical and spiritual rebirth. Joy, grieving, birth, and suffering are some of the life-changing emotions and events that occur in these environments. The structure itself should have interest and meaning. In my opinion, people in healthcare environments need more support and comfort than in any other environments. Healthcare facilities deserve our best design efforts and should be considered the most important structures of our age.
Ornamental band created by Pratt Design Studio, Ltd., depicting abstracted symbols of community and health.
The façade of the Condell Medical Center in Libertyville, Illinois, featuring the ornamental band seen in figure 1.
To translate that belief into the design of future buildings, architects will need to learn to be artists again. For most of our history as architects, we created the sculptures and art that was incorporated into our buildings. By reincorporating this training into the profession, it can be gradually reintroduced into architecture. Owners must demand a higher level of design, and the contractors must help us develop budgets, construction techniques, and methods of installation to enable us, together, to make structures of lasting significance.
What could this new design look like? One possibility is to look to the information age for inspiration. One creation of this era that I find particularly interesting is fractals. They are mathematic equations used to describe chaotic forms such as clouds and mountains. Fractals are self-similar, retaining their own identity as you zoom in over and over again. This self-similar detailing of buildings would maintain design integrity at any distance. As you approach, more detail is revealed.
One of our first attempts to incorporate this philosophy into our designs was in a hospital project in Libertyville, Illinois. We created a CAD model of an ornamental band depicting abstracted symbols of community and health (figure 1), and the contractor built it into a precast concrete form (figure 2). This process was simple, but the results on the building were significant.
By using emerging technologies, we can create structures of lasting value to our society. Cast resin is a cost-effective material for complex details. This material is both lightweight and durable, and it is suitable for both indoor and outdoor use. Stereolithography is a very promising new process; it creates a three-dimensional object directly from a CAD design. The computer model directs a laser beam into a pool of resin. As the laser heats the resin, it solidifies and “paints” the object layer by layer. Although it is mainly used as a method of creating prototypes and is currently constrained by size, the process suggests exciting possibilities for the future.
It is our inherent nature to integrate fine and applied art in architecture, and it is possible to implement these changes with the knowledge and tools we have today. Healthcare facilities are the obvious subjects, as they are the most important buildings of our generation. These structures are an investment in our own well-being, as well as a living record of our society for the future. Their importance must be illustrated by the care we take with their design and construction. HD