Spaces of Sickness and Wellbeing: art, architecture & experience
Ann-Marie Akehurst
To mark the launch of our new seminar series on the architecture of health – in its broadest sense – Ann-Marie Akehurst explores the evolution of our understandings of the relationship between architecture, health and environment, and the heightened relevance of these shifts today
Next month, the Society is launching a series of virtual seminars in partnership with the Wellcome Collection, entitled Spaces of Sickness and Wellbeing: art, architecture & experience, to be held at the University of London Institute of Historical Research. The seminars will embrace the holistic view of health architecture that has come to the fore in recent years, expanding outwards from hospital fabric, and placing the spaces of health in wider socio-cultural contexts in a manner that is both important and timely.
These seminars will take varied formats, with an inaugural session on 12 April uniting art and architectural historians from America and the UK to explore the imagery of epidemics, ‘Epidemics of Fear and the History of Medicine’, followed over the next two months by sessions on ‘Health beyond the Hospital’, including ‘Unconventional Spaces’ and ‘Outdoor Spaces’. Later in the year, archives and disabilities will be examined, including a session showcasing postgraduate and early-careers scholars. Registration for the Zoom events will be free and open to all.
Nursing of a wounded man at the Hôtel Dieu of Beaunes, France. Photographic postcard, c.1930. Courtesy of the Wellcome Collection.
It is already clear that, despite their prevalence in traditional academic studies, hospital architecture is about much more than wards and pavilion plans. This year’s Wolfson Economics Prize is offering £250,000 for proposals to reshape hospitals, improving patient experiences, clinical outcomes, staff wellbeing and integrations with wider health and social care. Announcing the prize, its founder, Lord Wolfson, emphasised the importance of improving ‘every aspect of the modern-day hospital – the aesthetics, internal logistics, communication, technology, workflow, hygiene systems and more’. The coronavirus pandemic has shown that such a rethink is vital: operating theatres have already been repurposed as Intensive Care Units; wards have overflown into carparks where ambulances deputise as emergency rooms; we’ve witnessed the impromptu establishment of Nightingale and Seacole centres; while GPs’ surgeries have become fortresses.
For better or worse, histories of health architecture have long remained tied up with the narrative of progress stemming from the Early Modern period. In Britain, from the early eighteenth century, regional voluntary hospitals created new spaces where the distinct medical professions encountered each other, and, in selected locales, established medical schools. These institutions and professional societies often commissioned magnificent architecture, though motivations for such philanthropic schemes were not always transparent. The medical profession’s preoccupation with pathogenesis dates from this era, as does its single-minded focus on the hospital as a place of cure. Until late last century, architectural scholarship has displayed a similar narrowness of focus, concentrating on the planning, organisation and fabric of places of health, largely divorced from wider social contexts.
Saint Peter and Saint John Healing a Lame Man and Saint Peter Raising Tabitha, 1853. Chromolithograph by Ludwig Grüner after Cesari Mariannecci, after Masolino’s mural at the Brancacci Chapel, Santa Maria del Carmine, Florence, 1425–27. Courtesy of the Wellcome Collection.
Yet, even at the time, medico-scientific knowledge was being generated and practised outside such establishments. As Britain’s empire expanded, international travel broadened the experience of managing infectious disease; war honed surgical skills concerned with dealing with traumatic injury; and, with the rise of political radicalism, dispensaries were established to address illness in the population at large. Community pharmacies were already part of a longstanding patchwork of spaces that generated therapies, whether physic gardens or apothecaries’ colleges. Moreover, long cultural traditions of wellbeing, such as balneology, persisted alongside medical institutions.
The Gellért Baths, Danubius Hotel, Budapest, c.1930. Courtesy of the Wellcome Collection.
The spaces of sickness and health extended well beyond the hospital campus, and recent scholarly activity has recognised this, embracing wider definitions. Knowledge of the relationship between health, architecture and environment is far from new – Vitruvius’ first-century Ten Books on Architecture establishes in the opening chapter that the education of the architect requires an enormous breadth of knowledge including ‘skill in physic [medicine] … to ascertain the salubrity of different tracts of country’. Traces of this ancient cultural tradition – of regarding engagement with the natural world as beneficial – crop up even in the Early Modern era, for instance at early psychiatric hospitals such as the York Retreat, founded in 1792, where Quakers placed the kitchen and garden at the heart of a meditational environment. Today, the relevance of these understandings is more apparent than ever. The therapeutic role of natural spaces, for instance, is currently all too clear, as so many of us turn to rejuvenating gardens, terraces and window-boxes to enhance our mental wellbeing.
This extension of research from the fabric of medical institutions to the wider environments of health is welcome, and perhaps could be taken further. Contemporary spaces of sickness and health could be considered to include the semi-public political spaces of Westminster and the private enclaves of regulatory agencies, in which decisions that govern public health are made. In addition, outreach programs are currently being run everywhere from radio stations to religious institutions, with the aim of raising coronavirus awareness and dispelling vaccine hesitancy. In the arts, Grayson Perry’s Channel 4 Art Club encourages and celebrates creativity for mental good health; Russell T. Davies’ outstanding drama It’s a Sin exposes the paradoxes associated with social stigmas around HIV/AIDS, in which hospital wards and family homes can become places of incarceration, while queer locales can be both liberating safe spaces and sites of infection.
These broad understandings of the complex relationship between sickness and health are reflected in the collections established under the terms of Sir Henry Wellcome’s will of 1936. As a result, the Wellcome Trust supports vital medico-scientific research, including the sequencing of the COVID-19 genome that underpins vaccine development. But its remit also extends to a free museum and library that aim to challenge how we all think and feel about health, and to create opportunities to consider deeply the connections between science, medicine, life, and art. Our partnership with the Wellcome Collection to co-convene this series of virtual seminars, in the company of some of the most exciting researchers in Britain and America, is one we are looking forward to greatly, offering as it does the prospect of engaging with the latest thinking on the architecture of health, and discovering future directions for exploration of this increasingly vital subject.
Introduced by Ross MacFarlane, Research Engagement Officer at the Wellcome Collection, the first session on Monday 12 April at 6pm will see scholars from America and the UK discussing the Art of Epidemics. On 26 April, Caitlin de Clercq (Columbia University) will chair a series of provocations concerning ‘Unconventional Spaces’ associated with formerly overlooked communities. On 26 April, Victoria Bates (University of Bristol) will chair papers on health and the environment in ‘Outdoor Spaces’.
The ambition for this series is to extend the reach of virtual programmes and to make them available to the widest community by following accessibility guidelines including closed captioning. The Society would like to thank our partners in this exciting project: Dr Victoria Bates (University of Bristol); Dr Caitlin DeClercq (Columbia University); Dr Alistair Fair and Harriet Richardson Blakeman (University of Edinburgh); Ross MacFarlane and Eoin O’Cearnaigh (Wellcome Collection); and Dr Rebecca Wynter (University of Birmingham).
Dr Ann-Marie Akehurst is Programmes Officer of the SAHGB and an independent scholar with a specialism in medical architecture.