How the atmosphere of a building affects patients

Unit Title : Dissertation

Word Count: 5396

Unveristy of Portsmouth 2015

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CONTENTS

List of Illustrations 2

Introduction 4

Chapter 1 - Plants and nature 14

Chapter 2 - Colours and Materials 21

Chapter 3 - Scale 26

Conclusion 31

Post Script 33

Biblography 34

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LIST OF ILLUSTRATIONS

Figure 1a-c, 4-6, 10-12, 14, 16-19, Primary source - Own work 23, 24, 27, 30-32, 34, 35 37-39, 42, 44, 45, 50, 51 54

Figure 7-9, 13 Dezeen. (2011). Champalimaud Centre for the Unknown by charles Correa Associates. Retrieved 2 January 2015, from http://www.dezeen. com/2011/06/14/champalimaud-centre-for-the-unknown-by-charles- correa-associates/

Figure 2, 20, 40, Maggie’s. (n.d.). The architecture and design of Maggie’s West London. Retrieved 2 January 2015, from https://www.maggiescentres.org/our- centres/maggies-west-london/architecture-and-design/

Figure 15, 46, 47, 49 Rogers Stirk Harbour + Partners. (n.d.). Maggie’s Centre. Retrieved 2 January 2015, from http://www.rsh-p.com/render.aspx?siteID=1

Figure 21, 22, 29, McIntyre, T., bdonline.co.uk. (2008). Rogers Stirk Harbour’s Maggie’s Centre at Charing Cross Hospital is a place like home. Retrieved 2 January 2015, from http://www.bdonline.co.uk/rogers-stirk- harbour%E2%80%99s- maggie%E2%80%99s-centre-at-charing-cross- hospital-is-a-place-like-home/3112980.article

Figure 25 Redfern . (2104). THE ‘WHICH INVOLUNTARY SURGICAL PROCEDURE ARE YOU?’ QUIZ. Retrieved 2 January 2015, from http://www.redjon. com/2014/04/involuntary-surgical-procedure-quiz/

Figure 26 www.fracademic.com. (n.d.). Serres royales de Laeken. Retrieved 2 January 2015, from http://fr.academic.ru/dic.nsf/frwiki/1530702

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Figure 28 News in Mind. (2014). Secure mental health beds crisis. Retrieved 2 January 2015, from http://www.newsinmind.com/general-news/secure- mental-health-beds-crisis

Figure 33 Design Curial. (2011). CHAMPALIMAUD CENTRE FOR THE UNKNOWN. Retrieved 2 January 2015, from http://www.designcurial.com/news/ champalimaud-centre-for-the-unknown

Figure 3 The Temples of Consumption. (n.d.). Champalimaud Center for the Unknown. Retrieved 2 January 2015, from http:// thetemplesofconsumption.blogspot. co.uk/2012/11/charles-correa- champalimaud-center-for.html

Figure 36 Nogueira, F., ArchTendências. (2013). Centro de Pesquisas Champalimaud / Charles Correa Associates. Retrieved 29 January 2015, from http:// archtendencias.com.br/arquitetura/centro-de-pesquisas-champalimaud- charles-correa-associates#.VMqQsGisVc4

Figure 41, 43, 52, 53 Mays, V., & Nogueira, D. (2011). Champalimaud Centre for the Unknown Features a Glass Bridge. Retrieved 2 January 2015, from http://www. architectmagazine.com/healthcare-projects/champalimaud-centre-for-the- unknown-glass-bridge.aspx

Figure 48 Bryant, R. (n.d.). Maggie’s Centre. Retrieved 2 January 2015, from http:// ecola-award.eu/en/project/nb/maggies-centre

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INTRODUCTION

In the Western World we spend 90% of our lives inside or within the proximity of buildings. (Dyckhoff, Channel 4, 2011) It seems reasonable to assume that the quality and atmosphere of this environment affects our health. Through the use of 2 examples this essay investigates how this understanding can be used in the design of space to have a beneficial effect on our health and well-being.

“…Atmosphere as the purpose of architecture...” Gernot Böhme (Jaeger, 2007) Swiss architect Peter Zumthor describes best what architectural atmosphere is

“...this singular density and mood, this feeling of presence, well-being, harmony... under whose spell I experience what I otherwise would not

experience in precisely this way...” (Birkhäuser. 2006).

Contemporary architecture should be as radical as contemporary music but as understandable as classical music. Architecture that is fragmented and which creates an environment of disharmony will confuse, clutter and kill our curiosity; however with the environment and atmosphere carefully considered architecture can embrace our inquisitiveness and nurture our well-being and health. ( Morphocode, 2013)

The ‘Atmosphere’ that pervades architecture can have numerous effects on our health. Architects need to not only recognise how the ‘Atmosphere’ affects us but also evaluate, understand and apply these ideas to future buildings. Figure 1a-1b shows how a building influences our well-being and creativity.

Figure 1a - Atmosphere

Figure 1b - Atmosphere

Figure 1c - Atmosphere

This essay will use 2 case studies; Maggie’s Centre West London: Charing Cross Hospital designed by Rogers Stirk Harbour & Partners and the Champalimaud Centre for the Unknown designed by Charles Correa Associates in Lisbon, to compare against 3 common ideas; plants and nature, colour and materiality and scale. This dissertation will explore how the ‘Atmosphere’ created in these buildings is used holistically to aid healing.

Both of these buildings are centers for the care of cancer patients and cancer research. The patients receive medical treatment and complimentary therapies such as, counselling and support. Although these buildings were built for the same purpose they have completely different approaches to the ‘Atmosphere’ and how this can influence the health of patients. A building can have a vast impact on people’s health and their mental well-being. There are claims that fresh air, nature and natural light promote healing and make people more focused and in a better frame of mind. Along with these, the use of colours and materials can greatly affect our health and ability to heal.

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Figure 2 - Outside the Centre in the summer

Figure 3 - Aerial shot of the Centre

THE CHAMPALIMAUD CENTRE FOR THE UNKOWN

The Champalimaud Centre for the Unknown is a state-of-the-art research and diagnosis centre for cancer and brain damage located in Lisbon, designed by the well-known Indian architect Charles Correa. Correa was born in 1930 and his work seeks to be modern but firmly rooted in Indian culture. His works have an emphasis on natural resources, energy and climate as a method for organizing the spaces within the building.

The site in Lisbon is located along the River Tagus just at the point where it meets the Atlantic Ocean. The river has been key to the history of Lisbon and Portugal as a whole. When the great navigators arrived at the mouth of the River, it must have taken a massive act of courage to venture into the open ocean, a journey into the unknown. It’s a metaphor for not only exploration but the building as well – it’s a journey into the unknown.

Correa’s building was not to be thought of as museum of modern art but a building of the highest levels of modern science and medicine to help people overcome real problems such as cancer and brain damage. Correa says

“…To house these cutting-edge activities, we tried to create a piece of architecture. Architecture as Sculpture. Architecture as Beauty. Beauty as therapy...” (‘Champalimaud Centre for the Unknown / Charles Correa

Associates’, 2011)

The Building has 3 areas; the largest of these is the hospital complex housing doctors, scientists and patients; the next area contains a theatre, exhibition halls, offices and other general services. The last area is an open air amphitheatre which was designed to serve the building as well as the wider city.

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Figure 4 - Map of Portugal

Figure 5 - Map of Lisbon

The two main buildings are linked by a glass bridge, this helps to create an ‘Atmosphere’ of harmony with the site as a whole aiding the ideas of healing. The buildings have been designed with a ramped 125m long route leading across the site, through the landscaped gardens towards the open sea.

The landscaped gardens draws the user into the site and towards the ramped route, throughout the gardens there are places for people to sit and reflect, making a very attractive place for patients receiving treatment. As you ascend you can only see the sky ahead of you but when you reach the top you see two stone monoliths from the nearby quarry, these monolith stone pillars create an ‘Atmosphere’ of reflection and makes the space very calm.

Behind these monoliths is a large body of water which connects, without any visual breaks, to the ocean ahead of it. Just below the surface of the water is a slightly convex oval object made from polished stainless steel; this object reflects the sky and clouds making an ‘Atmosphere’ of tranquility and serenity.

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Figure 6 - The building labeled

Figure 7 - Stone monoliths

8Figure 9 - First Floor Plan

Figure 8 - Ground Floor Plan

9Figure 11 - Stairs to the Amphitheatre

Figure 10 - Concept drawings

Figure 12 - Stairway in the reception

Figure 13 - Wall Figure 14 - Inner rainforest garden

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IMAGes

Figure 15 - Concept sketches

MAGGIE’S CENTRE WEST LONDON: CHARING CROSS HOSPITAL

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Maggie’s Centre’s are run by the Maggie’s Charity, which provides support, counselling and residential retreats for cancer patients. The charity was set up in May 1993, Maggie Keswick Jencks was told that her cancer had returned and was given only a few months left to live. At this point she joined an advanced chemotherapy trial and contrary to what doctors thought, she lived for another 18 months.

Before her death in June 1995, she and her husband worked closely with her medical team, to develop a new approach to cancer care. In order to live more positively with cancer, Maggie believed you needed treatment which included stress-reducing strategies, psychological support in a relaxed domestic setting. Maggie realized that the cluttered confusing spaces found inside modern hospitals were creating more stress and making it harder to deal with cancer, but in a more relaxed setting these problems were diminished.

Maggie’s husband, Charles Jencks is an American architecture critic and theologian who specialized in landscape architecture and sculpture. Charles thought it important that nature played a large role in the healing process of cancer patients, so all of the Maggie’s centres are surrounded with serenely planted gardens. The gardens allow the patients to experience the healing qualities of science found in nature and the spirituality that nature can show.

Charles explains his ideas and theories as

“...To see the world in a Grain of Sand … is to find relationships between the big and small, science and spirituality … I explore metaphors that underlie

both growing nature and the laws of nature...” (Charles Jencks, n.d.)

This idea of looking at the big and the small is an idea carried across every Maggie’s Centre.

Figure 16 - Map of the UK

Figure 17 - Map of London

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Figure 18 - Entrance to the Centre

Figure 19 - Outside in January

Figure 20 - Looking into the kitchen

In November 1996, the first Maggie’s Centre opened in Edinburgh. Since then 14 new centres have opened, each one being designed by a celebrated architect. The Architect for the West London Centre was the practice of the world renowned architect Richard Rogers, Rogers Stirk Harbour + Partners; the practice’s ethos is to try and reject the ideas of the past, whilst encouraging a technological future, and wherever possible using modern technologies to enhance the environment within a building. Throughout his work Rogers tries to incorporate designs and concepts from the early modernistic movement.

Roger’s concept came from the idea of a heart being protected by 4 supporting walls

“...The idea was to try to minimise the overbearing impact of Charing Cross Hospital. The roof, the landscaping, the hearth inside, the views out, each was to take you away from the hospital and the bustle of the road...” (‘The

architecture and design of Maggie’s West London’, n.d.)

The West London Centre is a two story pavilion with a grand hovering roof canopy that reaches high above the walls creating a protective environment over a series of intimate internal courtyards and gardens.

The exterior of the building is covered in a deep orange render which puts a protecting arm around the core of the building, making it its own place without denying it is a part of the surrounding city.

This approach was taken to make it feel like an open house within the city, retaining Maggie’s idea that cancer patients would benefit from receiving support in a more domestic setting, surrounded by gardens and thoughtfully designed landscape to form an homely ‘Atmosphere’ where a person can really focus on themselves and their treatment.

Figure 21 - Ground Floor Plan

Figure 22 - First Floor Plan13

CHAPTER 1 – PLANTS AND HEALING

The Ancient Greeks (8th Century BC) recognized the benefits of nature and plants in the healing process. Temples to the God Asklepios, the God of Medicine, were designed to surround patients with plants and nature to create an ‘Atmosphere’ of healing and harmony.The Ancient Chinese (16th Century BC) studied the natural environment, developing Feng Shui,

“…the most favorable location of both people and things in a particular environment…” (Schweitzer, Gilpin, & Frampton, 2004).

Feng Shui works with Chinese medicine and Ying-Yang, every building and person is believed to have its own unique energy and these energies are enhanced by the natural environment and the plants planted nearby. Chi, gives life, it is the difference between being a corpse or being a living being. Having more Chi can enhance a person’s health and their mental well-being (Energy Arts, n.d.). Promoting good Chi and creating the right ‘Atmosphere’ by harnessing the ideas of Feng Shui can have a substantial impact on the health and well-being of patients.

During the middle ages, Monasteries were the driving force behind medical advances offering healing to all levels of society without discrimination, royalty and peasants alike visited monastic gardens for healing and the tranquil environment they instilled.

In the Nineteenth Century, Florence Nightingale documented the negative effects of poor hospital design by observing the survival rate at different facilities. She noted that there was a lower survival rate when the hospitals were over crowded, had poor ventilation and weren’t connected to nature.

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Figure 23 - Greek Temple

Figure 24 - Monastic cloister

Right from the 2nd millennium BC to the 21st century Botanical Gardens have been in existence and are places where plants are collected, cultivated and displayed; the gardens contain an array of different plant species from many different countries, with the focus of preserving plants from around the world. Botanists brought back seeds and plants and grew them in specialised environments, mimicking the place of origin. It enabled the West to gain the knowledge of how plants can be used to aid the healing process, but inadvertently Botanical Gardens became a place of healing with many people visiting them for the tranquil environment they create.

Gardens and plants have played an important role in history, they have enabled us to create ‘Atmosphere’s of healing but also to bring knowledge from all over the world on ways to improve nature and the healing environment they create.

The effects noted by Florence Nightingale and seen in Botanical Gardens have been further recognized today with studies showing how three to five minutes spent looking at spaces with trees, flowers or water can reduce anger, anxiety and pain, it can also help relaxation, blood pressure, and brain activity (Sternberg, 2010).

A 1993 study carried out by Uppsala University Hospital in Sweden selected 160 intensive care patients and introduced them to six different conditions after undergoing their surgery; simulated windows showing an open, wooded stream or a shadowy forest, abstract paintings, a white or blank wall. The survey proved that patients who viewed the stream scene were less anxious and needed fewer doses of medication than those who looked at the abstract art, shadowy forest, or blank wall.

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Figure 25 - 19th Century hospital ward

Figure 26 - Typical Botanical garden

Figure 27 - Uppsala University study, Does nature have an effect on healing of patients?

The advancement of medicine during the 20th and 21st centuries focused on diagnosing, curing and treating. Critics have said that hospitals and clinics have overlooked the fact that these advances bring negativity; noisy, cluttered, institutional places with very little access to nature, and minimal interest in the effects of these techniques on the patient’s physical and mental wellbeing. Hospitals have become intimidating, dehumanizing institutions with multiple unclear entrances, disorientating circulation patterns, vague signage and significant restrictions on visitors and plants, creating an ‘Atmosphere’ of confusion and oppression causing patients to feel more anxious and unwell; evidence shows that staying in hospital following a short operation can increase postoperative pain and anxiety (Franklin, 2012).

To combat criticism, hospitals need to be rationally planned and have clear signage, they also need to be designed so they create small spaces surrounded by nature where a person can sit and enjoy the surroundings – enhancing their healing ability but also reducing anxiety and stress. In a recent survey of architects and hospital directors, 82 percent agreed that

“...the design of outdoor space should be one of the most important considerations in the design...” (Franklin, 2012)

Nature in hospitals creates an ‘Atmosphere’ of healthy, clean living with the aim of promoting wellbeing. Architects and hospital directors now see how having access to nature can greatly improve staff efficiency levels and reduce recovery time for patients.

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Figure 28 - 21st Century hospital corridor

PLANTING IN THE MAGGIE’S CENTRE WEST LONDON

A fundamental part of all Maggie’s Centres is the landscaping. In the West London Centre the purpose is to bring the standalone building into the wider hospital site, while creating a distinct environment around and inside the building to generate a therapeutic ‘Atmosphere’ that adds to the healing potential of the building.

The landscaping draws together the existing hospital and the new centre, wrapping the buildings in trees to lower the noise and pollution levels whilst keeping a leafy backdrop from the inside; these trees also help create an ever changing streetscape that contrasts itself against the rust red coloured building. The landscape helps reduce the fear of the hospital and creates an ‘Atmosphere’ that is focused on the Centre instead of the hospital complex.

The building is approached from the hospital; a woodland walk leads to the building between trees that have been surrounded with decorative plants, ending in a public courtyard surrounded by white Magnolias which blossom in spring. Figure 30 shows the planting that surrounds the Maggie’s Centre.

When approaching the entrance to the building there are bamboo groves and sculptures that provide the patients with a place to meditate and contemplate. Inside the building, there are a series of small courtyard gardens that create protected external rooms under the ‘floating’ roof that distinguishes the building from the street. All the rooms in the building open onto an internal garden, providing nature and a calm space for patients. All of this is achieved whilst using ideas of sustainability as the building is naturally ventilated, creating an ‘Atmosphere’ of wellbeing and healing. The open spaces inside the building are lavishly planted and are designed in such a way that starts the process of acceptance and restoration.

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Figure 29 - Nature surrounding the Centre

Figure 30 - Plan showing the gardens

Throughout the building Mediterranean herbs are grown to be used in the kitchen, Patients are encouraged to help tend for these herbs.

The gardens are broken into three key areas: northern, eastern and Southern winter gardens. These are an extension of the internal areas that are only accessed from inside the building; the inner courtyard gardens are planted with interesting year round plants to provide a level of interest no matter what the season. As part of the therapeutic healing, patients are encouraged to be actively involved in the maintenance of the gardens to enhance their health.

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Figure 31 - Trees planted outside the centre

Figure 32 - Section highlighting the planting

PLANTING IN THE CHAMPALIMAUD CENTRE FOR THE UNKOWN

When approaching the Champalimaud Centre the user is greeted by the ‘Jardim Anna Sommer’ - . The garden is a tribute to the founder’s mother; the vast, green space was designed with the idea of using no boundaries or fences, using grass helps indicate that the area has been returned to the public. Along the stone pathway, trees are planted providing shade and shelter from the Portuguese sun.

The interior garden was designed to be the most breath-taking part of the main building. This garden is covered by a glass roof which creates a microclimate that is ideal for plants from Brazil, Africa, India, and the Far East. These plants are used to promote the idea of Feng Shui, it channels the good chi promoting health and calmness, but also uses the idea of a rainforest as a calm place to aid in the healing process. The interior rainforest garden can be classed as a Botanical Garden, which ties the design into the site, as Portuguese explorers used the river to access the Atlantic sea.

A walkway guides the visitors through this exotic and tropical environment, along the walkway there are rest areas to encourage the patient or visitor to pause and enjoy the calming ‘Atmosphere’. This garden is open to the public so that everyone can enjoy the peace and serenity of the lush green space.

Located inside the clinical building of the Champalimaud Centre is a Zen Garden exclusively for the use of patients. This garden was designed specifically so that the patients could be allowed to receive their treatment in an ‘Atmosphere’ of serenity and well-being whilst having a strong connection to nature, which has been thought to aid healing.

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Figure 33 - Interior Garden when built

Figure 34 - Interior Garden in 2014

To help create this ‘Atmosphere’ the patients friends and family can accompany them, turning a clinical procedure into a more enjoyable experience.

The space was designed to bring the tranquility of the garden into the hospital and create a place where nature takes a prominent role in healing. Figure 35 shows where the gardens are located.

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Figure 35 - Plan showing the gardens

Figure 36 - View into interior garden and treatment rooms

Figure 37 - Section highlighting the planting

CHAPTER 2 – COLOURS AND MATERIALS

Colours and materials can also impact on our moods, outlook and mental well-being. Each colour stimulates a different response from every individual but there is some correlation between colours and the effect they have, this is the same for materials.

A study undertaken by the University of British Colombia, looked at the Blackfriars Bridge in London and suicide rates. It found that when the bridge, made of iron, was painted green there was a 30% decrease in the number of suicides. The study showed dark green, has a positive motivating effect on an individual; males in particular.

The primary colours of red, yellow and blue each have a different effect on a person’s mood and mentality.

Red stimulates the adrenal gland and the neurons causing an invigorating effect, however overstimulation can cause stress, frustration and anger.

Serotonin is a chemical in the brain that is essential for a happy mood and positive mental outlook. Studies have shown that yellow can increase Serotonin levels in humans but also enhance concentration and metabolism. On the other hand, over stimulation has some negative side effects; short temper and fatigue. Interestingly studies have found that babies cry more in a yellow room.

Blue has a soothing effect on the brain, boosts creativity and denotes loyalty. Materials that are blue, appear to be lighter, hence why heavier weights are blue in a gym. But blue can cause depression and can been seen as a ‘cold’ colour, making a room feel cooler than it actually is (Human N Health, 2013.).

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Materials can affect people as well as colours. In a study carried out by the University of British Colombia, it was found that using wood, in a room lowered patient stress and sympathetic nervous system activation. Dark wood, such as mahogany, makes a space feel small and intimate; it also gives a warming effect. Whereas lighter materials, European Oak for example, makes a space feel open and airy.

The texture of a material also can have an effect on us. Smooth materials are seen to be more clinical, expensive and clean; for example, polished concrete. However, materials that have a rougher course texture, gives the impression of being unfinished and cheaper. Rough textured materials can also give an oppressive feel. The combination of colour, texture and finish affects the individual in such a way; by material choice one can completely change the feeling and sense of a space. (Allen Novak & Richardson, LEED AP, AIA, and Glidden Professional, 2013)

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COLOUR AND MATERIALS IN THE MAGGIE’S CENTRE WEST LONDON

In the Centre, the predominant aspect of the building’s approach to colour and materiality is the wrapping rendered wall. The bright rust red wall brings patients and visitors into an inspiring interior with cosy intimate rooms, bright spaces and movable walls. The walls provide changeable spaces that, give the ability to host anything from intimate chats, to help overcome and accept diagnoses to exercise classes.

Being a combination of red and yellow, Orange inherits the effects of both. It is interpreted as a warm colour that helps well-being. Orange has a benefit in all hues; it expresses nature, creates a feeling of playfulness and invites a friendly happy ‘Atmosphere’.

The interior of the building has been designed so that it feels very familiar; the flooring is made from polished concrete giving it a warm effect. All the other aspects of the interior are made from wood, helping create an environment of healing and relaxation.

All the woods are soft woods unless they need to be hard wearing such as the door thresholds. The materials used in the project are natural and are not inherently expensive, but it’s about the feeling they create. For example the hand rails; an aluminum hand rail feels different to a hand rail wrapped in leather, one is more clinical the other is more ‘homely’.

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Figure 38 - Section showing rendered wall

Figure 40 - Inside the kitchen

Figure 39 - The rust red wrapping wall

COLOUR AND MATERIALS IN THE CHAMPALIMAUD CENTRE FOR THE UNKOWN

The Champalimaud Centre has a very modern clean feeling that can be almost classed as clinical. Harmonizing with the idea of a modern lab the curved buildings are built using Portuguese Lioz Limestone. Portuguese Lioz Limestone has an off-white, neutral colour; white is used by many medical institutions to show sterility. White also creates a comfortable secure feeling; with its own gracefulness it implies stability and subtle warmth. It also helps emphasize nature and a natural environment. (Allen Novak & Richardson, LEED AP, AIA, and Glidden Professional, 2013)

The pathway that leads you through the ‘Jardim Anna Sommer’ is made from granite cobble stones in keeping with local tradition; whilst in contrast, the inside of the buildings is floored in ceramic tiles, again giving a very modern feel.

At the top of the pathway two concrete monoliths frame the view of the small pool with the stainless steel convex oval object just breaking the surface of the water and the Atlantic Ocean behind, helping connecting the buildings to the wider site.

In the main medical building there are elliptical double height cut outs in the walls, providing visual connections to nature and outside but also to the different floors in the building.

The interior ‘Rainforest’ garden is encased in floor to ceiling glass panels which bring the outside into the treatment centres. Connecting the medical building to the exhibition hall is a 21 meter long glass bridge supported by tension cables. The glass is laminated curved glass to give the user the feeling of nothingness and a true connection to the site as a whole.

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Figure 41 - View into the medical building

Figure 42 - The pathway towards the sea

When the sun hits the building the Limestone shines with warmth that helps the patient to feel at ease but also highlights the nature and beauty of the space.

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Figure 43 - View towards Lisbon

Figure 44 - Section showing the Portuguese Limestone

CHAPTER 3 – SCALE

“...Ceiling height affects the way you process information ... You’re focused on the specific details in lower ceiling conditions...” (Anthes, 2009)

The scale and size of a space has a huge impact on people’s health but also their mood. In 2007, the University of Minnesota conducted a study to see if there was a connection between ceiling height and how people think. 100 people were selected to be in one of two rooms, one room had a 2.5 meter ceiling and the other a 3 meter ceiling. In the rooms participants were asked to group 10 objects into their own categories. People in the room with a higher ceiling came up with more abstract categories and the people in the smaller room came up with more concrete rational categories. Figure 45 illustrates this study. Higher ceilings makes people feel much less physically and mentally constrained.

The study showed that people could think more freely and have a better calmer outlook in a room with a higher ceiling, but lower ceilings prompted a more detailed, statistical outlook.

“...If you’re in an operating room, maybe a low ceiling is better. You want the surgeon to get the details right...” (Anthes, 2009)

The way a building is designed, can create playfulness within the building. By changing the heights of the ceiling and the scale of the rooms, the architect can have a vast impact on our mental and physical well-being. When it comes to medical centres, many of them try to save space and thus have lowered ceilings. This can enforce the idea of an establishment, but also hinder the patients healing ability and detract from the ‘Atmosphere’ of the space.

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Figure 45 - How room size affects creativity

SCALE IN THE MAGGIE’S CENTRE WEST LONDON

Retaining Maggie’s ideas, the Centre has been designed to create an ‘Atmosphere’ of homeliness and warmth. You can see in figure 48 how the spaces in the building are formed, it shows the entrance with the double height space and the rest of the buildings. The counselling rooms have an intimate feeling with the use of warm concrete and wood but also slightly lower ceilings. Whereas the entrance to the centre welcomes you with a double height space and exposed materials with large expanses of glass, which leads to some more enclosed rooms where the materials are more subtle and create a warmer ‘Atmosphere’. For example, the kitchen has a lower ceiling and a warmer colour palate allowing patients to focus on the healing process of cooking but also encouraging stillness.

On the other hand, the dining room, located next to the kitchen, has an open double story height ceiling with lots of glass and all the materials exposed, these exposed materials have a calmer, happier, cooler feeling than those found in the kitchen; even though they are the same materials.

This creates an ‘Atmosphere’ of openness and well-being, helping the patients to talk and accept their diagnosis in a friendly setting. Inside the intimate spaces there is at least one wall that doesn’t fully touch the ceiling, so even in these more enclosed areas there is still an ‘Atmosphere’ of openness.

Throughout the building, the architect has taken full advantage of the ‘floating’ roof, in the full height spaces it boosts the ‘Atmosphere’ and enhances the quality of the spaces but in the lower height spaces it increases the feeling of comfort and being at home.

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Figure 46 - The flexible spaces inside the Centre

Figure 47 - View from the entrance

Figure 48 - Section through the building

Through the use of scale, the Centre creates a feeling of tranquility and serenity, where a person can really focus on themselves. It allows the patient to come to terms with their diagnosis and realize what is important; their treatment, healing and well-being.

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Figure 49 - The ‘Floating’ roof

Figure 50 - Section showing different heights

SCALE IN THE CHAMPALIMAUD CENTRE FOR THE UNKOWN

Being a medical treatment and research facility, the Champalimaud Centre has many aspects to the design that use different scales to create different effects.

From the large open spaces of the atrium and gardens to the more focused laboratories and treatment rooms shown in figure 51. The whole building is very thought through, so the treatment rooms create a calm and safe environment promoting health and well-being, whereas the public spaces welcome and encourage movement and exploration.

When approaching the building the sense of scale is impressive, the first thing that you see are the large medical building and the theatre building both made from the Portuguese Limestone linked with the glass bridge.

As you walk along the pathway, the public building takes a less prominent role and the medical building retains its large limestone wall. In the walls are double story elliptical cut outs. This gives the walls a transparent feeling; the public can see in and the patients can see out without feeling spied on.

However as you reach the top of the path, right in front of you there are two enormous concrete pillars that dwarf their surroundings and focus the eye onto the ocean in front. Upon entering the main medical building the reception is a double height space with huge expanses of glass either side which gives the whole entrance an ‘Atmosphere’ of modern clean openness.

The glass roof to the inner ‘rainforest’ is nearly 30m in height, enhancing the idea that the space is a rainforest and helps the plants to grow. However in contrast to this, the treatment rooms which face this garden, have a lower roof with calm natural colours and textures creating a modern medical

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Figure 51 - Section showing different heights

Figure 52 - Double story cut outs in the medical building

centre where people are focusing on healing. Whislt using scale to have an impact on the ‘Atmosphere’ of the space, the Champalimaud Centre has a consistent ‘Atmosphere’ of healing and well-being

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Figure 53 - Interior medical building, showing the glass

Figure 54 - Height changes in the buildings

CONCLUSION

In conclusion planting, colour and scale each make a difference to a person’s health and well-being but when they are combined they have a huge effect on the ‘Atmosphere’ of a building and its users. Both buildings approach the 3 topics in different ways. They use the idea of nature and gardens for the same result, to maximize the patient’s ability to get the most out of their treatment. Architects not only now realize how important nature is in the healing process but are also starting to evaluate, understand and apply these ideas to contemporary medical buildings. People are realizing that the ‘Atmosphere’ of a building and the use of nature can improve the life of cancer patients.

Materials and colours vary between the buildings, the Maggie’s Centre focuses on creating a ‘homely’ feeling that makes the patient feel at ease through the use of warm materials that would not be out of place in the home, whereas the Champalimaud Centre creates a modern feeling with the emphasis on healing through connecting to nature and the wider site but also the use of neutral coloured limestone and large expanses of glass.

Using the ideas of colours and their impact on us, is nothing new but architects are now using it in a modern way so that it has a positive impact on our health, well-being and perception of a building and the ‘Atmosphere’ they create. Both architects use colour to create an ‘Atmosphere’, that is unique to their building.

Whereas the approach both architects take to the scale of the buildings is completely different, Rogers keeps the ideas that Maggie thought was important – making the centre feel like a home. Using mezzanine floors to break up the double height to create a homely ‘Atmosphere’. Drawing on his modern background Correa’s design is grander in scale with a clear

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focus on healing, the openness of his design makes for a light airy interior. Throughout the building there are subtle hints to the scale and how it has been designed, the stone and glass panels are overly large helping reinforce the idea that people in the centre are working to solve a larger problem.

A key aspect which makes each building a success, is that each architect has taken the location into careful consideration when making choices on the surrounding nature, colours and materials and the overall scale. In London the light generally is softer and cooler, which would make a white building feel cold and oppressive but orange will bounce the light making a cold day feel warm and no matter the weather, create a welcoming environment. In Lisbon you wouldn’t have these issues as the Mediterranean light has more ‘warmth’ and colour in it, so a white building doesn’t feel cold but can feel comforting and welcoming.

From this essay it is clear that our health is affected by the environment and particularly the buildings that surround us and the ‘Atmosphere’ they create. From the very beginning of human civilization right to the present day people have realized that some part of our surroundings and the buildings included in them effect our mental and physical well-being. Even Neanderthals decorated and interacted with the environment they were surrounded with; creating paintings that depicted their lives and nature.

Many architects are learning from the past and accumulating this information to make buildings that are more sensitive to their effect on humans and their ability to heal.

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POSTSCRIPT

The NHS are spending over £5 billion each year treating cancer patients and the cost to society as a whole is in excess of £18 billion (Ellison, Department of Health, 2013). But by implementing the knowledge that architects are gaining about how the environment and ‘Atmosphere’ can affect our healing, this can greatly reduce the cost by maximizing the efficiency of treatments and reducing post-operative care needed. This can only lead to more considerate buildings with the patients as the key focus.

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