The Decline of the Hospital as a Healing Machine

This chapter explores how the modern hospital came to be seen and planned as a non-healing environment during the twentieth century. The key turning point, I argue, arrived just after the Second World War, when governments in Britain and North America began to fund hospital construction with the goal of making hospitals the centerpieces of their healthcare systems. This decline maps a change in medicine cogently summarized by sociologist Norman Jewson as the “disappearance of the sick-man.” ¹ In modern medicine, the symptoms and feelings of being sick expressed by the patient became less important than medical testing, diagnosis, and treatment of his or her body parts. In the hospital patients lost authority over the narrative of their illness as well as their organic bodies, which became subject to medical inspection by both medical students and doctors. In parallel, architects began to promote the idea that the hospital environment need not explicitly contribute to healing the sick body, but must instead supply flexible support to the constantly progressing routines of biomedical practice. A host of “emerging and expanding activities,” summarized a 1972 editorial in Progressive Architecture, “require multipurpose, flexible spaces geared to advances in communications, audiovisual systems, and diagnosis.” ²