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Summer 1999
That Human Touch
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purposes. The emergency facilities are grouped on the first floor, with bed-sized elevators to convey patients from two rooftop helipads. Operating and other interventional rooms are concentrated on the second floor, mechanical services on the third, neuropsychiatry on the fourth and the Mattel Children's Hospital on the fifth.

Patient rooms take up the top three floors, clustered in "pods" of 26 around the perimeter of the building. Their number was reduced to 525 from the present 830 in order to focus attention on the most acute cases. Others will be treated at UCLA/Santa Monica Hospital or as outpatients. Each room is private - a strong preference expressed by focus groups - and is a generous 315 square feet, allowing many procedures to be conducted in the rooms using sophisticated equipment, and providing a convertible sofa for a friend or relative to sleep on. Each of the 26 elevators is dedicated to use by patients, medical or service staff. Patients and visitors circulate in what is called in theaters the "front of house," leaving the stage and rear of house to professionals.

"Unlike an office, which can be laid out in radically different ways, the choices are limited in organizing a hospital," says C.C. Pei. "Proximity is a crucial issue. There are a great number of small rooms so you need a lot of circulation. A big block requires more internal corridors, which use up space. So it made functional as well as environmental and aesthetic sense to articulate the five stories above the three-level podium, breaking up the mass of the building and pulling natural light into the center. Light defines space - it is what architecture is all about."

Light also affects the human body, as Susan Mortensen M.N. '87, clinical director of Nursing, is quick to point out. "Patients can become psychotic through sensory deprivation or sensory overload," she observes. "It's tremendously important to experience the natural cycle of light and dark and to be wheeled out into the sun." In leading one of the core planning groups, Mortensen says she tried to think of herself as a patient or family member. "How would I feel about the entrance and the rooms" Visitors used to be closely regulated; now they enjoy 24-hour access to loved ones as a right, and we have to provide them with space and privacy.

Another key feature was advocated by doctors who wanted spaces that would generate chance encounters among their peers, fostering a free-flowing exchange of ideas without having to wait for a scheduled meeting. For an outpatient clinic in Birmingham, AL, C.C. Pei had designed a grand staircase for just that purpose, so he responded enthusiastically to the proposal, putting corridors around the outside perimeter of the building wherever possible. As he points out: "An enclosed corridor is like a tunnel and you speed along it. But you may linger in a corridor where you can see out, and if there's a wider bay and the sun is streaming in, it's a better place to meet than a private office, where you would pull the blind down to protect yourself."

The basic forms of the hospital were set early on and were shaped by the internal configuration, as well as by the desire not to overwhelm the rest of the south campus. The effect of pods rising from a podium may be compared to that of the campus' Chiller/Cogenerator Plant to the north, where a massive low block is topped with ducts and rounded containers that dissolve into the sky. Says C.C. Pei: "Duke encouraged us to think of this dominant building as a piece of the

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