One of the fascinations of Architecture is its wedding of aesthetic aspirations with the most mundane practicalities. Architects want their buildings to connect with viewers viscerally and, in the case of healthcare facilities, with healing effect. But users' perception of a building would be severely impacted if the MEP doesn't work and the walls and ceilings fall in on them. To achieve structures meeting all the demands placed on them requires collaboration and coordination of a wide variety of building specialists.

The ultimate written expression of this I've ever seen is a 1994 book I came across recently called The Making of Beaubourg: A Building Biography of the Centre Pompidou, Paris (The MIT Press), by British architectural critic and author Nathan Silver. The story of this now 33-year-old arts center/museum/library, famously sporting all its mechanicals and pedestrian circulation on the exterior, is mind-boggling in its complexity and sweep, and rich in telling details. It makes one (at least me) wonder about the real stories behind the magnificent and intriguing healthcare facilities we discuss routinely in this magazine.

The Pompidou Centre is, of course, the brainchild of Renzo Piano and Sir Richard Rogers, collaborating at the start of their legendary careers. They had won, fair-and-square, a French-sponsored competition involving nearly 700 entries, with the blue-ribbon architectural judges feeling drawn to their ingenious approach to ensuring maximum flexibility of the interior. The subsequent story has several fascinating twists and turns-the adventures of a British architectural firm working hand-in-glove with French civil administrators being one-but the most amazing aspect to me is the fact that the designers and the world-renowned structural engineering firm Arup and Partners pretty much made up the details of this unique building as they went along.

This sample quote from Nathan Silver expresses it well: “The issue was the resolution of the composed elements. Near the beginning of the design development, the designers didn't know what those elements would be, where they would come from, how they would be made; and most of them would have to be very new because it wasn't usual to put things like switches and electric motors on the outside of a building.” Luckily for them, the French construction management firm assigned to work with them succeeded in getting contractors to accept the notion that fabricating new products on-the-fly was “normal.”

The ingenious structure of the building using cast steel “gerberettes”-massive Tinkertoy-like beams with holes in the ends to allow flexible construction and reduction of steel-designed by Arup's resident genius Peter Rice, is another striking facet, as was the struggles of the German steel manufacturer, Krupp, to get the tempering right.

I recommend visiting your favorite bookstore or Web site to find this book (I picked it up in a Paris bookstore). Meanwhile-and hopefully I'm not going too far out on a limb saying this-I think Editor-in-Chief Todd Hutlock would welcome building biographies (or at least Reader's Digest versions of same) from our readers. Any interesting blow-by-blows of healthcare projects you worked on? Please feel free to contact Todd or me at our listed e-mail addresses. HD

Healthcare Design 2010 August;10(8):136