Icon for brain health
The Cleveland Clinic Lou Ruvo Center for Brain Health Las Vegas, Nevada
Project: The Cleveland Clinic Lou Ruvo Center for Brain Health
Project Sponsor: Larry Ruvo and Keep Memory Alive
Architect: Gehry Partners, Los Angeles, California
Photography: Eric Kabik/Retna; Matt Carbone Photography; Dahl Photography
Project Construction: The Whiting-Turner Contracting Company
Building Square Footage: 61,000
Total Building Cost: $80 million
Cost/Sq. Ft.: $2,300 for the Life Activity Center
What happens when a philanthropist, a star architect, and a world-class medical center agree on a mission? The result would be something quite possibly looking and functioning like the Lou Ruvo Center for Brain Health. It's the latest addition to the unique world of Las Vegas, Nevada, architecture-except this structure has a more personal meaning than most: It's the $80-million expression of a man's grief for his father, victimized by Alzheimer's disease 16 years ago. Nevada beverage tycoon Larry Ruvo remembers the years of confusion caused by Lou Ruvo's early symptoms of the disease-the surprise at lost memories, the shock during initial doctor visits of seeing others more fully advanced in the disease, his mother's eventually crippling efforts providing care for her husband. "I didn't want to see my family or friends ever go through what we went through,... says Ruvo. He decided then and there to raise the money and create a healthcare center with two purposes: to focus on easing the course of Alzheimer's disease for patients and caregivers and moving toward a cure, and to gain major worldwide attention for the cause. He found a model for caregiving in his own backyard: "When Siegfried and Roy gave their final performance at our fundraising gala, Roy was able to return (from his mauling by a lion) only because of the constant care and supervision provided by Siegfried; I can't think of a better caregiver than Siegfried was.... The goal, after 11 years of fundraising: have world-famous "starchitect... Frank Gehry design the building. "I told Frank I want to put your celebrity to work for us.... After requesting that the Center focus as well on Huntington's disease, the scourge of some close acquaintances of his, Gehry agreed. As the building neared completion, Ruvo presented it as a gift to the Cleveland Clinic. Seeking an outpost in the west, the Clinic under its architecture-buff leader Toby Cosgrove, MD, had initially looked toward Los Angeles, but was intercepted by Larry Ruvo and his dream. The result, which officially opened this past May, is one of the country's (and world's) unique healthcare projects. Here offering their takes on it are Larry Ruvo, Chairman and Founder of Keep Memory Alive; William Peacock, the Clinic's Chief Operating Officer; Michael Modic, MD, Head of the Clinic's Neurological Institute; and Frank Gehry.
Larry Ruvo: The purpose of the exterior was to create excitement and let the world know that I and the people of Las Vegas are serious that we want to alter the course of this disease. We've raised tens of millions of dollars, and a large part of our success is due to Frank Gehry. The building was conceived in Las Vegas, designed in Los Angeles, engineered in Germany, fabricated-more than 500 pieces-in China, and assembled by The Whiting-Turner Contracting Company and my management rep of 17 years, Oussama "O.B.... Beyhoum (O.B. Construction), in two years.
William Peacock: Frank Gehry Partners employ a tool (Digital Project) that was extraordinarily helpful during construction and facilitated tracking. The roof and window system were complex. Minor adjustments were performed onsite but, generally, we had a very good fit for pieces fabricated across the Pacific. Our manager stated that this was like assembling a Swiss watch and he was right. In general, we gained great appreciation for the value of Building Information Modeling (BIM).
Frank Gehry: In using Digital Project, we bring in our consultants at the earliest possible stage so that we can use them as resources as we design the building and require all of them to use the program. Every part is modeled by the various trades. By doing this, clashes between the various trades are detected before construction begins, which saves time and money in the field. The model also facilitates material procurement and construction of the building.
Peacock: It was enlightening working with Frank Gehry's team. His Los Angeles office is filled with a creative energy that is unique and inspiring. The methodology they used to conceive and design the building was a combination of sketches, wooden blocks and computer-aided effort, but there was nothing angular/rectangular in any of the models traditional healthcare design is based upon.
Ruvo: Getting an architect and a client together is like a marriage; fortunately, I had a good one here. Frank was completely engaged and terrific to be with. He expressed exactly what he wanted but listened and made changes based on what he heard. When all is said and done, though, I don't hire experts and tell them what to do. He is the expert, and he designed an incredible building, always keeping patients, caregivers, and programs forefront in his mind.
Gehry: Whatever the comments pro or con, the most important thing for me is that the building works for those who use it. My client is happy, and has had only positive feedback from visitors and patients.
Michael Modic, MD: The flow of the building is designed to minimize stress for patients and caregivers. Reception has no chairs-patients go immediately from registration to a patient suite. Patient conference areas and departure lounges are designed to avoid contact between patients who are at different stages of the disease, which can be a traumatic experience, as was experienced by Larry Ruvo's father. The patient and family areas are very comfortable and noninstitutional, with couches and chairs like you would find in a living room. Natural light plays a huge part in this, with all the patient suites along the exterior with a wall of floor-to-ceiling glass. The clinical modalities are organized for efficiency: all the imaging is on the first floor, and has teleconferencing capability enabling our team of neuroradiology specialists in Cleveland to read and interpret the images. The patient suites share the second floor with physical therapy, consultation areas, and a library. Along with an emphasis on early diagnosis of neurologic disease and optimal support for caregivers, there is also space for research involving, for example, pharmaceutical trials and social support programming.
Gehry: We worked very closely with the people at Keep Memory Alive (Larry Ruvo's philanthropic organization) and the Cleveland Clinic to understand their goals and methods of working. At the end o
f the day we listened to them and worked hard to make sure that the building functions for them. Because these spaces are intended primarily for diagnostics rather than treatment, there were not as many stringent requirements as in many healthcare facilities. This made it easier. We designed the spaces to have a lot of natural light, warm finishes, wood, and nice colors. I think we made spaces that people will feel comfortable in.
Peacock: The Center has two distinctive components-the Activity Center and the multistory patient care area-joined by an open space exposed to the elements. The construction of the exterior and the interior of the Activity Center roof was challenging and astounding to watch. Man-lifts and staging were coordinated with precision. Watching the craftsmen install the interior drywall from layers and layers of scaffold was Sistine Chapel-like in its complexity and skill. The patient areas are organized clearly, pure in materials, and respectful of patients who may be challenged in navigating the space.
Ruvo: I think the interior was some of Frank Gehry's best work. A lot of what we've done was based on me and my mother's experience of a father/husband with Alzheimer's. We wanted immediate diagnosis, proper follow-up care, and an environment letting caregivers know how important it is for them to take care of themselves. I think of it like the airplane oxygen mask, where they tell you to put it on yourself before you help others. We want caregivers to be in good physical and mental condition because, like the book says, it is a 36-hour day.
Gehry: We worked with the firm TransSolar, who are climate engineers from Germany, and with them we implemented the following:
low-E glass and ceramic frit on the glass to reduce solar gain inside the building;
an HVAC system designed to cool the smallest possible area while maintaining human comfort levels. Therefore, the auditorium is conditioned only up to 10 feet off the ground, while the remaining 60 feet is left unconditioned. This reduced the cooling load enormously, resulting in energy savings; and
interior shades of the Activity Center, additionally reducing solar gain; and
The medical building was outfitted with mostly north-facing glass, a shaded trellis on the south, and white walls and a white roof. Because of the excellent natural light and narrow floor plates, there is little need for artificial lighting during the day.
Ruvo: I told Frank Gehry that I wanted to expose his celebrity to find a cure for this disease. I think the work he has done on the Activity Center has achieved this.
Gehry: I designed the banquet hall as a chapel for Larry's father, Lou. I feel that way when I am inside it. I didn't do it consciously, but it is a very special space. The curves of the wall and ceiling create an environment that is simultaneously uplifting and intimate. Also, there is a lot of natural light coming in from the windows and skylights, which is unique for event spaces, but I think it's nice to have a connection to the city. HD
Healthcare Design 2010
The Cleveland Clinic Lou Ruvo Center for Brain Health is being offered as one of many tours at the HEALTHCARE DESIGN.10 conference on Saturday, November 13, 2010. For more information, visit http://www.hcd10.com.
For further information, visit http://www.keepmemory alive.org.
Healthcare Design 2010 July;10(7):36-42