Healing

Healing through Architecture
by
Jennifer Lynda Beggs
A thesis
presented to the University of Waterloo
in fulfillment of the
thesis requirement for the degree of
Master of Architecture
in
Engineering
Waterloo, Ontario, Canada, 2015

© Jennifer Lynda Beggs 2015
AUTHOR’S DECLARATION
I hereby declare that I am the sole author of this thesis. This is a true copy of the thesis,
including any required final revisions as accepted by my examiners.
I understand that my thesis may be made electronically available to the public.
iii
ABSTRACT ACKNOWLEGEMENTS
How can spaces operate as active ingredients body’s most effective ways of healing is
in the healing process to maximize the through the means of releasing endorphins
body’s healing potential? which can reduce pain and swelling, lead
to feelings of euphoria, modulate appetite,
Numerous studies show evidence of the and enhance the immune system’s response.
body’s ability to “self-heal” when put into Endorphins are natural, not addictive (unlike
positive healing environments. This healing many drugs) and often have the same effect
is enabled by the ability of the body to ‘tap as traditional drugs such as morphine and
Thank you to my committee, Maya Przybylski, Andrew Levitt, and Rick Haldenby for all of
into our internal pharmacies’ by activating codeine.
your patience and guidance walking me through this exciting endeavour.
the body’s powerful neurochemicals such as
endorphins.1 This thesis explores the relationship between
Thank you, Doug Lintula, for reviewing and editing my thesis document. Your editorial skills
environments and the chemical reactions in
were appreciated in helping me put the final touches on my thesis.
The terms curing and healing are often used the body that enable healing. The research
interchangeably but have distinct definitions. reviews several healing spaces, comparing
Thank you, Randy, for all of your love and support throughout my thesis work, especially for
The term curing refers to the relief of the traditional healing spaces with contemporary
all of your help with editing various drafts of my thesis and helping me with Revit.
symptoms of a disease or condition. The term ones, analyzing both positive and negative
healing refers to the alleviation of a person’s examples in terms of the architecture’s
Thank you, Dad, for your unwavering love and for walking me through all of my presentations.
distress or anguish. In order to fully take ability to help augment healing. The research
All of our practice runs helped me tremendously, and your dedication means the world to me.
advantage of the body’s healing potential, reviews the focus patient in cancer treatment,
environments hold the ability to stimulate the investigating their specific challenges and
Finally, thank you, Mom. Thank you for all of the courage you showed during your journey
senses and become active healers themselves. then finally introduces the site, Grand River
with cancer. Your strength continues to inspire me and has made this thesis so meaningful.
This helps minimize negative effects of stress Hospital in Kitchener, Ontario, in which
Your opinions and insight on this unbearable journey helped me immensely.
on the body, guiding a positive physical and the design development is situated. The
I love you, Mom, my Angel.
psychological response to environments proposed design interventions focus on how
in ways that maximize the effectiveness of architecture can have a positive impact on
crucial medical treatments and procedures. In patients receiving chemotherapy. In order
order to take advantage of the body’s healing to realistically move towards fully realized
pharmacies, environments must prevent the wellness, hospitals need to take a holistic
body from weakening due to stress. approach to treat a patient’s physical illnesses,
psychological health, emotional hardships,
Stress is the body’s biggest obstacle in healing, and physiological response. “Ultimately it is
and many contemporary hospitals inflict so the senses that need to be revitalized as it is
much stress on patients that it actually slows an integral part of healing.”2
down healing, counteracting the medications
and treatments patients receive. One of the
1) Sternberg, Esther and Tippett, Krista. “Esther Sternberg - the

Science of Healing Places.” On Being, last modified 2013, accessed 2) “Grandnm”. “Healing Architecture.” Scribd., last modified
Sept 17, 2014, http://www.onbeing.org/program/the-science-of- Apr 8, 2014, accessed Sept 24, 2014, http://www.scribd.com/
healing-places/4856/audio?embed=1. doc/216951537/HealingArchitecture.
iv v
Dedicated in loving memory to my amazing Mother
Sue Beggs
April 29, 1954
November 11, 2014
vii
TABLE OF CONTENTS
iii Author’s Declaration Part IV: Healing Environments 57 History of Healing Spaces
iv Abstract 60 Architectural Placebo Effect
v Acknowledgements 66 Existing Hospitals - Positive Examples
vii Dedication 70 Hospitals in Ontario that offer Chemotherapy
viii Table of Contents 72 Existing Chemotherapy suites
x List of Figures
xviii List of Illustrations Part V: Cancer & the Focus Patient 82 About Cancer
xxxi Opening Quote 84 Focus Patient undergoing Chemotherapy
Part I: Introduction 03 Architecture and Patient Part VI: Intervention Site 96 Ideal vs. Practical
08 Thesis Structure 98 Hospital Interior Architecture
Part II: Effects of Stress 12 Stress Part VII: Design Development 106 Design Development Goals
14 Poorly Designed Spaces 114 Design Development Proposals
16 Limits to Medicine 115 Design 1: Wile Wall
18 Reducing Stress in Healing Spaces 129 Design 2: Scentcubator 5000
135 Design 3: Vertical Gardens
Part III: “Brain Pharmaceuticals” 24 Brain Pharmaceuticals 142 Design Development Evaluations
28 Traditional Drugs vs. Brain Pharmaceuticals 144 Where can Architecture offer further healing?
30 The Power of the Mind 146 Crucial Moment: Arrival
35 Four Senses, Mindmap 150 Grand River Regional Cancer Centre Analysis
38 Project Studies
46 Precedent Projects 152 Conclusion
154 References
viii ix
LIST OF FIGURES
PART I p. 30 Fig. 3.2 Commonweal Retreat Center, Kohler House

Ibid.
p. 6 Fig. 1.1 The first Maggie’s Centre was built in Edinburgh and opened in
1996, designed by Charles Jencks p. 32 Fig. 3.3 Nursing Homes can be the most unforgiving places to cope.
“Maggie’s at Sixteen.” City Three Point Zero., last modified March 2, Watson, Rita. “our Nursing Home Parents: MDs, Meds, Cultural Issues,
2014, accessed December 30, 2014, Part 2.” Psychology Today., last modified April 2, 2013, accessed June
https://citythreepointzero.wordpress.com/. 13, 2015, https://www.psychologytoday.com/blog/love
andgratitude/201304/ournursinghomeparentsmdsmedsculturalissues
PART II part2.
p. 14 Fig. 2.1 Canadian emergency waiting rooms become uncomfortable and p. 33 Fig. 3.4 Senior Residence, Peter Zumpthor
crowded. Wat, Timothy. 2014. “Moments of Spiritual Engagement in
Bebee, David. 2010. “The Wait is Over: Laval Inventor Tackles Waiting Architecture.” Masters of Architecture, University of Waterloo. 26.
Room Frustration.” Toronto Star, June 28, 2010.
p. 39 Fig. 3.5 Exterior render of Split Time Cafe
p. 17 Fig. 2.2 Woman demonstrating different positions women can choose “Split Time Café.” Philippe Rahm Architectes., accessed Oct 1, 2014,
to use while giving birth to suit their own comfort in Germany. http://www.philipperahm.com/data/projects/splittimescafe/index.html.
This physically and psychologically helps the mother through a
comfortable birthing process. p. 41 Fig. 3.6 Harmonorium Installation
Pregnant in America. YouTube. Directed by Steve Buonaugurio “Hormonorium.” Philippe Rahm Architectes., accessed Sept 27, 2014,
and Mandy Buonaugurio. 2008. Accessed 03 November 2014, http://www.philipperahm.com/data/projects/hormonorium/index.html.
https://www.youtube.com/watch?v=yEcYSMmJrw8.
p. 43 Fig. 3.7 Diurnism Installation
p. 17 Fig. 2.3 Woman demonstrating different positions women can choose “Diurnism.” Philippe Rahm Architectes., accessed Oct 1, 2014,
to use while giving birth to suit their own comfort in Germany. http://www.philipperahm.com/data/projects/diurnisme/index.html.
This physically and psychologically helps the mother through a
comfortable birthing process. p. 44 Fig. 3.8 The Rain Room installation enables people to walk among the water
Ibid. without getting wet.
“Rain Room.” RANDOM., accessed 30 December, 2014,
PART III http://randominternational.com/work/rainroom/.
p. 30 Fig. 3.1 Commonweal Retreat Center, Pacific House p. 44 Fig. 3.9 Nocti Vagus Restaurant in Berlin is a restaurant completely in the
“Commonweal Retreat Center.” Commonweal., last modified June 1 dark.
2015, accessed Feb 5, 2015, http://www.commonweal.org/. Report about Dark Restaurant NOCTI VAGUS (Berlin). YouTube.
Directed by YouTube User anike1990. 2012.
x xi
p. 45 Fig. 3.10 Light Therapy at bus stops has been shown to decrease stress in p. 48 Fig. 3.17 Material palette of the Centre for Cancer and Health is very neutral
Sweden. and soothing
Boyle, Rebecca. “To Fight Winter Blahs, Sweden Offers Light Therapy at Ibid.
the Bus Stop.” Popular Science., last modified Nov 29 2012, accessed Oct
25, 2014, http://www.popsci.com/technology/article/2012-11/fight- p. 49 Fig. 3.18 Interior view of the Centre for Cancer and Health
winter-doldrums-swedish-electrical-company-showers-bus-stations-uv- Ibid.
light.
p. 50 Fig. 3.19 Southdown Institute
p. 45 Fig. 3.11 NASA Light Bulb helps promote sleep. Remy, Ruane. 2014. “Southdown has Right-Sized.” Catholic Register,
“The NASA Sleep Promoting Light Bulb.” Hammacher Sept 14, 2014, 13.
Schlemmer., accessed Jan 19, 2015,
http://www.hammacher.com/Product/Default.aspx?sku=86494. p. 50 Fig. 3.20 Thorncrown Chapel, Arkansas
“Architecture.” Thorncrown Chapel., last modified 2015, accessed Jun 4,
p. 46 Fig. 3.12 Commonweal Retreat Centre, Pacific House 2015, www.thorncrown.com/architecture.html.
“Commonweal Retreat Center.” Commonweal., last modified Jun 1
2015, accessed Feb 5, 2015, http://www.commonweal.org/. PART IV
p. 46 Fig. 3.13 Commonweal Retreat Centre, Kohler House p. 57 Fig. 4.1 Thomas Guy’s Hospital was designed around a central courtyard
Ibid. in London, opened in 1726.
“St. Thomas’ Hospital.” The Old Operating Theatre., accessed June 3,
p. 47 Fig. 3.14 Maggie’s Centre, Nottingham, Communal Space in Kitchen 2015, http://www.thegarret.org.uk/guys.htm.
“Nottingham Interior.” Bustler., last modified March 1, 2014,
http://www.bustler.net/index.php/article/maggies_centres_to_exhibit_ p. 57 Fig. 4.2 Hôpital Lariboisiere, Paris opened in 1854.
starchitect_cancercare_center_designs_in_new_yo/. Benchaum. “Lariboisière Hospital, Interior Courtyard.” Wikipedia., last
modified March 31, 2009, accessed May 31, 2015, https://en.wikipedia.
p. 47 Fig. 3.15 Maggie’s Centre, Dundee, Scotland, (Space to spend quiet time org/wiki/Lariboisi%C3%A8re_Hospital#/media/File:H%C3%B4pitalLar
alone) iboisi%C3%A8reCourInt%C3%A9rieur1.JPG.
Ibid.
p. 48 Fig. 3.16 View of the interior courtyard at the Centre for Cancer and Health
“Center for Cancer and Health Danish Architecture Centre.” Danish
Architecture Centre., accessed Oct 2, 2014,
http://www.dac.dk/en/daclife/copenhagenxgallery/cases/centerofcancer
andhealth/.
xii xiii
p. 58 Fig. 4.3 St. Thomas Hospital in London built between 1861 and 1865. p. 63 Fig. 4.10 Rehab Centre, Courtyard
“St Thomas’ Hospital, and Statue of King Edward VI / London and its Ibid.
Environs in the Nineteenth Century.” The British Museum., accessed
May 31, 2015, http://www.britishmuseum.org/research/collection_ p. 63 Fig. 4.11 Rehab Centre, Walkway
online/collection_object_details/collection_image_gallery.aspx?assetId= Ibid.
803336001&objectId=3271537&partId=1.
p. 63 Fig. 4.12 Rehab Centre, Pool
p. 58 Fig. 4.4 Hicks U.S. General Hospital, Balitmore Ibid.
E. Sachse & Company. “Hicks U.S. General Hospital, Baltimore,
Maryland, 1861.” Maryland Historical Society., accessed May 31, p. 64 Fig. 4.13 Two of Joana Johnston’s images, part of her exhibit exploring
2015, http://www.mdhs.org/digitalimage/hicksusgeneralhospital institutional architecture.
baltimoremaryland1861. Johnston, Joanna, C. “Here. This is what I feel.” Joanna C Johnston,
Wordpress., accessed June 3, 2015,
p. 60 Fig. 4.5 Maggie’s Centre, Edinburgh https://joannacjohnston.wordpress.com/herethisiswhatifeel/.
“Maggie’s Centre, Edinburgh.” Maggie’s., accessed Jan 3, 2015,
https://www.maggiescentres.org/ourcentres/maggiesedinburgh/. p. 66 Fig. 4.14 Dyson Centre for Neonatal Care in the Royal Hospital in Bath,
England designed by Feilden Clegg Bradley Studios, Architects
p. 61 Fig. 4.6 Maggie’s Centre, Nottingham which opened in July 2011.
Glancey, Jonathan. “Maggie’s Centre: The Jolly Green Giant.” The Maddox, Lucy. “Can the Design of Hospitals Help Patients Recover
Guardian., last modified November 13, 2011, accessed March 20, Faster?” Gizmodo., last modified Nov 25 2014, accessed Dec
2015, http://www.theguardian.com/artanddesign/2011/nov/13/maggies 9, 2014, http://gizmodo.com/can-the-design-of-hospitals-help-patients-
centrenottinghampiersgough. recover-faste-1663083331.
p. 61 Fig. 4.7 Maggie’s Centre, Glasgow p. 68 Fig. 4.15 Still under construction, this is what an inpatient room may look
“Maggie’s Centre, Glasgow.” Page \ Park., accessed April 10, 2015, like at HRH.
http://pagepark.co.uk/projects/maggiescentreglasgow. Christie, Nathan. “Touring the Huge New Humber River Hospital,
Part Two.” Urban Toronto., last modified Apr 1 2015, accessed May 5,
p. 62 Fig. 4.8 Rehab Centre, Aerial View 2015, urbantoronto.ca/news/2015/04/touring-huge-new-humber-river-
“Rehab Basel.” MIMOA; Mi Modern Architecture., last modified 2015, hospital-part-two.
accessed Jan 2, 2015, www.mimoa.eu/projects/Switzerland/Basel/
REHAB%20Basel. p. 69 Fig. 4.16 Exterior view of the“View Dynamic Glass” which carefully controls
light penetration.
p. 62 Fig. 4.9 Rehab Centre, Courtyard Ibid.
Ibid.
xiv xv
p. 69 Fig. 4.17 “View Dynamic Glass” can stop light from penetrating through by PART VII
the touch of a buttom, without the use of curtains.
Ibid. p. 140 Fig. 7.1 Grand River Chemo Suite, Existing (2015)
Photograph taken by author.
p. 76 Fig. 4.18 Existing chemotherapy suites
Listed clockwise, starting with top left image: p. 148 Fig. 7.2 Existing Parking Garage (2015)
piratstudenterna.se. “Chemotherapy Room Design.” Image Stack., Photograph taken by author.
accessed December 10, 2015,
http://imagestack.co/135714778chemotherapyroomdesign.html. p. 149 Fig. 7.3 Existing View at Front Entrance (2015)
Photograph taken by author.
News Editor. “New Chemo Room for Western Isles Hospital.” Hebrides
News Today., last modified August 3, accessed December 10, 2014, p. 151 Fig. 7.4 Lobby
http://hebridestoday.com/2010/08/newchemoroomforwestern Photograph taken by author.
isleshospital/.
p. 151 Fig. 7.5 Chemotherapy Waiting
“My First Visit to the Chemo Suite.” BE of Good Cheer., accessed April Photograph taken by author.
30, 2015, http://hodgkins.caryschmidt.com/cancerpictures/.
p. 151 Fig. 7.6 Examination Room Corridor
“All about Therapy.” Therapy Articles, Blogspot., accessed December Photograph taken by author.
10, 2014, therapyarticles.blogspot.com.
p. 151 Fig. 7.7 Entrance
Mukherjee, Sy. “the Sequester is Forcing Cancer Clinics to Deny Photograph taken by author.
Chemotherapy to Thousands of Elderly Americans.” Think Progress.,
last modified April 4, 2013, accessed December 10, 2014, p. 151 Fig. 7.8 Lobby
http://thinkprogress.org/health/2013/04/04/1819811/sequestrationcancer Photograph taken by author.
clinics/.
p. 151 Fig. 7.9 Doctor Visit Waiting Area
p. 77 Fig. 4.19 Existing chemotherapy suite at the Grand River Regional Cancer Photograph taken by author.
Centre (2015)
All photographs taken by author.
xvi xvii
LIST OF ILLUSTRATIONS
PART II p. 26 Ill. 3.4 Pituitary Gland in Brain

Illustration by author. Information provided from:
p. 12 Ill. 2.1 Alarm Reaction “Definition of Pituitary Gland.” Medicine Net., accessed September
Illustration by author. Information provided from: 29, 2014, http://www.medicinenet.com/script/main/art.
Malkin, Jain. 1992. Creating a Healing Environment. In Hospital asp?articlekey=4915.
Interior Architecture., 13-17.
p. 26 Ill. 3.5 Vagus Nerve
p. 18 Ill. 2.2 View through a window may influence recovery from surgery [1984 Illustration by author. Information provided from:
study done of patients recovering from gall bladder surgery]. “Viva Las Vagus Nerve.” Subtle Yoga., accessed October 2, 2014, http://
Illustration by author. Information provided from: subtleyoga.com/220/
Ulirch, Roger S. Effects of Healthcare Environmental Design on
Medical Outcomes. p. 28 Ill. 3.6 Traditional Drugs vs. Brain Pharmaceuticals
Illustrations by author. Information from (top to bottom):
p. 19 Ill. 2.3 Robert Wood Johnson Foundation report (2003) shows the benefits Jynto. 2011. Dopamine molecule,
of “Better Hospital Design.” http://commons.wikimedia.org/wiki/File:Dopamine_3D_spacefill.png.
Illustration by author. Information provided from:
Sternberg, Esther, and Tippett, Krista. Esther sternberg the science Mills, Ben. 2008. Morphine molecule,
of healing places. in On Being [database online]. 2013 [cited Sept http://commons.wikimedia.org/wiki/File:Morphine-from-xtal-3D-balls.
17 2014]. Available from http://www.onbeing.org/program/thescienceof png.
healingplaces/4856/audio?embed=1.
Sbrools. 2007. Melatonin molecule,
PART III http://commons.wikimedia.org/wiki/File:Melatonin-3d-CPK.png.
p. 24 Ill. 3.1 Holistic Healing QWerk. 2008. Codedine molecule,

Illustration by author. http://commons.wikimedia.org/wiki/File:Codeine3D.png.
p. 24 Ill. 3.2 Passive (left) vs. Active (right) stress coping strategies p. 36-7 Ill. 3.7 Four Senses Mindmap
Illustration by author. Illustrations from left to right, top to bottom:
“Historic Churches of Boston.” Complete Pilgrim., last modified April
p. 25 Ill. 3.3 Brain Pharmaceuticals 12, 2014, accessed Oct 10, 2014,
Illustration by author. Information provided from: http://thecompletepilgrim.com/historicchurchesboston/.
Cooper, Belle B. “The Science of Time Perception: Stop it Slipping
Away by Doing New Things.” Buffer Social., last modified July 2, “Hormonorium.” Philippe Rahm Architectes., accessed Sept 27, 2014,
2013, accessed December 11, 2014, https://blog.bufferapp.com/the http://www.philipperahm.com/data/projects/hormonorium/index.html.
scienceoftimeperceptionhowtomakeyourdayslonger
xviii xix
“Diurnism.” Philippe Rahm Architectes., accessed Oct 1, 2014, p. 39 Ill. 3.10 Coloured lights and type of furniture help control the fatigue level in
http://www.philipperahm.com/data/projects/diurnisme/index.html. users.
Illustration by author. Information from:
“Lifeways Complementary Health and Education Centre.” The Therapy “Split Time Café.” Philippe Rahm Architectes., accessed Oct 1, 2014,
Centre., last modified July 25, 2008, accessed Sept 30, 2014, http://www.philipperahm.com/data/projects/splittimescafe/index.html.
http://www.thetherapycentre.co.uk/home.htm.
p. 40 Ill. 3.11 Increasing the level of nitrogen reduces the oxygen level from 21%
“Split Time Café.” Philippe Rahm Architectes., accessed Oct 1, 2014, to 14.5%, which is found at altitudes of about 3000m.
http://www.philipperahm.com/data/projects/splittimescafe/index.html. Illustration by author. Information from:
“Hormonorium.” Philippe Rahm Architectes., accessed Sept 27, 2014,
“Center for Cancer and Health - Danish Architecture Centre.” Danish http://www.philipperahm.com/data/projects/hormonorium/index.html.
Architecture Centre., accessed Oct 2, 2014,
http://www.dac.dk/en/dac-life/copenhagen-x-gallery/cases/center-of- p. 40 Ill. 3.12 The environmental elements of the installation decrease the amount
cancer-and-health/. of melatonin released in the brain, making people feel less fatigued.
The increase nitrogen creates a slight disorientation in users.
Rusek, Joan C. “Federated Church’s Bainbridge Labyrinth Draws People Illustration by author.
from the Region.” Cleveland. Sun News, last modified July 21, 2013,
accessed Oct 1, 2014, p. 41 Ill. 3.13 The intense lights and lack of oxygen make people feel euphoric and
http://www.cleveland.com/chagrinfalls/index.ssf/2013/07/federated_ less tired.
churchs_bainbridge_l.html. Illustration by author. Information from:
“Hormonorium.” Philippe Rahm Architectes., accessed Sept 27, 2014,
Eliasson, Olafur. “The Weather Project.” TATE., accessed Oct 8, 2014, http://www.philipperahm.com/data/projects/hormonorium/index.html.
http://www.tate.org.uk/whatson/exhibition/unileverseriesolafureliasson
weatherproject/olafureliassonweatherproject. p. 42 Ill. 3.14 Orange has a wavelength of over 570nm; therefore, the colour
triggers the brain to release melatonin, causing the body to feel
p. 38 Ill. 3.8 Colours such as yellow, orange and red make users feel more tired tired.
due to the presence of melatonin, whereas green, blue and purple Illustration by author. Information from:
make people feel less tired. “Diurnism.” Philippe Rahm Architectes., accessed Oct 1, 2014, http://
Illustration by author. www.philipperahm.com/data/projects/diurnisme/index.html.
p. 38 Ill. 3.9 The release of melatonin can manipulate the body into thinking it is p. 42 Ill. 3.15 The orange triggers the body to release melatonin making people
a different time of day, making the body feel more tired or awake. feel fatigued.
Illustration by author. Illustration by author.
xx xxi
p. 43 Ill. 3.16 The orange light and music from speakers makes people feel very p. 71 Ill. 4.3 There are 115 hospitals in Ontario that offer chemotherapy
fatigued. Illustration by author. Information from:
Illustration by author. Information from: “Regional Cancer Programs.” Cancer Care Ontario., last
“Diurnism.” Philippe Rahm Architectes., accessed Oct 1, 2014, http:// modified Nov 3 2009, accessed Dec 10, 2014,
www.philipperahm.com/data/projects/diurnisme/index.html. www.cancercare.on.ca/cms/one.aspx?portalId=1377&pageId=8958.
p. 49 Ill. 3.17 Spatial Qualities of the Centre for Cancer and Health p. 72-3 Ill. 4.4 Comparison between five chemotherapy suites from around the
Illustration by author. Information from: world
“Center for Cancer and Health Danish Architecture Centre.” Danish Illustration by author. Information from (left to right):
Architecture Centre., accessed Oct 2, 2014, http://www.dac.dk/en/dac “New Chemotherapy Unit.” Royal Cornwall Hospitals., accessed
life/copenhagenxgallery/cases/centerofcancerandhealth/. January 15, 2015, http://www.rcht.nhs.uk/RoyalCornwallHospitalsTrust/
WorkingWithUs/ClinicalSiteDevelopmentPlan/NewChemotherapyUnit.
p. 51 Ill. 3.18 Attention Restoration Theory by Dr. Marc Berman aspx
“The Nature of Things with David Suzuki, Dreams of the Future, “3D Model of Proposed £2.2million Chemotherapy Unit is Unveiled.”
Science of Natural Therapy.” CBC. CBC, last modified 2014, accessed Northern Devon Healthcare., last modified May 14, 2014, accessed
Oct 10, 2014. February 10, 2015, http://www.northdevonhealth.nhs.uk/2013/05/3d
modelofproposed22millionchemotherapyunitisunveiled/.
PART IV
“Asian Breast Centre.” Asian Hospital and Medical Centre., accessed
p. 59 Ill. 4.1 Evolution of healthcare from home to the ‘Podium on a Platform’ December 15, 2014, http://www.asianhospital.com/healthcareservices/
Illustration by author. Information from: asiancancerinstitute/.
Burpee, Heather. 2008. “History of Healthcare Architecture.”
Wood, Cyndi. “MCMH Plans New Cancer Centre.” Maine Coast
p. 67 Ill. 4.2 Conceptual plan of the Dyson Centre for Neonatal Care in the Memorial Hospital., accessed February 10, 2015, http://mcmhospital.
Royal Hospital in Bath, England designed by Feilden Clegg Bradley org/site/index.php?option=com_content&view=article&id=1745:mcmh
Studios, Architects which opened in July 2011. plansnewcancercenter&catid=191:news&Itemid=579.
Maddox, Lucy. “Can the Design of Hospitals Help Patients Recover
Faster?” Gizmodo., last modified Nov 25 2014, accessed Dec 9, Patient Guilde to Cancer Care. 2010: Tom Baker Cancer Centre and the
2014, http://gizmodo.com/can-the-design-of-hospitals-help-patients- Holy Cross Site
recover-faste-1663083331.
p. 74 Ill. 4.5 Site plan of Grand River Hospital, Kitchener, Ontario, 1:2000
Illustration by author.
xxii xxiii
p. 75 Ill. 4.6 Evaluating Grand River Regional Cancer Centre’s chemotherapy p. 86 Ill. 5.7 7-DAY TREATMENT CYCLE
suite Chemotherapy/Radiation (x12 Repeat)
Illustration by author. Information provided by Perkins + Will. Illustration by author.
PART V p. 87 Ill. 5.8 14-DAY TREATMENT CYCLE

Chemotherapy, Neupogen (x8 Repeat)
p. 82 Ill. 5.1 Causes of Death in Canada, 2011 Illustration by author.
“Cancer Statistics at a Glance.” Canadian Cancer Society., accessed p. 87 Ill. 5.9 14-DAY TREATMENT CYCLE
February 20, 2015, http://www.cancer.ca/en/cancerinformation/ Chemotherapy, Neulasta (x8 Repeat)
cancer101/cancerstatisticsataglance/?region=bc. Illustration by author.
p. 82 Ill. 5.2 Stats projected for 2014 p. 88-9 Ill. 5.10 Comparing Schedules and Anxiety Levels: Chemo Patient vs.
Illustration by author. Information from: Healthly Person
“Cancer Statistics.” Waterloo Wellington Regional Cancer Program., Illustration by author.
last modified 2014, accessed Apr 4, 2015,
www.ww-rcp.on.ca/cancerstatistics/. p. 90 Ill. 5.11 Time and Role of Patient
p. 83 Ill. 5.3 Estimated new cases of cancer, Canada 2014
Illustration by author. Information from: p. 90 Ill. 5.12 Axo, Grand River Regional Cancer Centre
“Cancer Statistics at a Glance.” Canadian Cancer Society., accessed Illustration by author.
February 20, 2015, http://www.cancer.ca/en/cancerinformation/
cancer101/cancerstatisticsataglance/?region=bc. PART VI
p. 84 Ill. 5.4 Typical cycle for patients receiving chemotherapy (typically cancer p. 96 Ill. 6.1 Comparing elements of a forest to an urban centre
patients) Illustration by author.
p. 97 Ill. 6.2 Thesis Focus
p. 84 Ill. 5.5 Cancer Fatigue Illustration by author.
Evans, Dr M. “Cancer Related Fatigue.” Sunnybrook., accessed Nov 1, p. 99 Ill. 6.3 Hospitals and prisons both have one things in common: lack of
2014, http://health.sunnybrook.ca/cancer-fatigue-content/video/. control.
p. 85 Ill. 5.6 Common Symptoms of Chemotherapy
xxiv xxv
p. 100 Ill. 6.4 Where Architecture can offer Healing? p. 121 Ill. 7.10 Environmental elements help patient stay awake.
p. 101 Ill. 6.5 Different areas visited at the hospital during typical visit p. 121 Ill. 7.11 Environmental elements help patient fall asleep.
PART VII p. 122 Ill. 7.12 Wile Wall releases natural chemicals to help reduce stress.
p. 106 Ill. 7.1 Design Development Evaluation Guidelines
Illustration by author. p. 123 Ill. 7.13 Structure of the Wile Wall
p. 108 Ill. 7.2 Project Evaluations - Experimental Projects
Illustration by author. p. 124 Ill. 7.14 Proposed Plan, 1:100
p. 109 Ill. 7.3 Project Evaluations - Medical Projects
Illustration by author. p. 125 Ill. 7.15 Proposed Section, 1:50
p. 112 Ill. 7.4 Elements required for chemotherapy
Illustration by author. p. 126-7 Ill. 7.16 Patient’s view of the Wile Wall during treatment
p. 113 Ill. 7.5 Schematic Axo, Grand River Regional Cancer Centre
Illustration by author. p. 130 Ill. 7.17 Axo of Scentcubator
p. 116-7 Ill. 7.6 Elements used in Wile Wall Design
Illustration by author. p. 131 Ill. 7.18 Coloured light fills the Scentcubator to reduce patient stress.
p. 118-9 Ill. 7.7 Natural Scents
Illustration by author. p. 131 Ill. 7.19 Top of Scentcubator extends to suit needs of patient and scent
travels from plants through tubes into Scentcubator.
p. 120 Ill. 7.8 Arteries in the human body that can be used to measure pulse, an Illustration by author.
indication of the body’s stress level.
Illustration by author. p. 132 Ill. 7.20 Chemo Suite (South side) with Scentcubators
p. 120 Ill. 7.9 Stress detecting chair
xxvi xxvii
p. 132 Ill. 7.21 Chemo Suite (South side) with Patient Activity p. 149 Ill. 7.32 Proposed Drop-off Area at the Front Entrance of the Cancer Centre
p. 133 Ill. 7.22 Plan of Chemo Suite (South side) with Scentcubators, 1:150, shows p. 150 Ill. 7.33 Ground Floor Plan, Grand River Hospital, 1:500
how each scentcubator can be personalized with light and scent to Illustration by author.
suit patient’s specific needs
Illustration by author. p. 150 Ill. 7.34 Upper Floor Plan, Grand River Hospital, 1:500
p. 136-7 Ill. 7.23 Axo, Vertical Gardens
Illustration by author. p. 152 Ill. 7.35 Ground Floor Plan with proposed Entrance Dome, 1:500
p. 138 Ill. 7.24 Grand River Chemo Suite, 1:150
Illustration by author. p. 153 Ill. 7.36 The daily average low (blue) and high (red) temperature with
percentile bands (inner band from 25th to 75th percentile, outer
p. 139 Ill. 7.25 Vertical Garden Section, 1:40 band from 10th to 90th percentile) of Toronto, Ontario.
Illustration by author. Illustration by author. Information from:
“Average Weather for Toronto, Ontario, Canada.” Weather Spark.,
p. 141 Ill. 7.26 Grand River Chemo Suite, Proposed accessed June 1, 2015,
Illustration by author. https://weatherspark.com/averages/28179/TorontoOntarioCanada.
p. 142-3 Ill. 7.27 Chemo Suite Proposal Evaluations

p. 144 Ill. 7.28 Suggestion of an ideal chemotherapy healing space

p. 145 Ill. 7.29 Where Architecture can offer Healing?

p. 146 Ill. 7.30 Detailed Site Plan, Grand River Hospital, 1:2000 illustrating
important phases of the entrance to the hospital
p. 148 Ill. 7.31 Proposed Drop-off Area at the Front Entrance of the Cancer Centre
xxviii xxix
“ If place can make you happy,
can it also make you well? „
Esther Sternberg
xxxi
PART I: INTRODUCTION
Introducing thesis focus and design development goals
1
ARCHITECTURE AND PATIENT
How can the architecture of healing space “Architecture has its own realm. It has
become an integral part of healing itself? a special physical relationship with life.
I do not think of it primarily as either a
How can architecture have an active role message or a symbol, but as an envelope
in the healing process? and background for life, which goes on,
in and around it, a sensitive container for
the rhythm of footsteps on the floor, for the
concentration of work, for the silence of
sleep.”1
Spaces are good mediums for affecting

emotions. In places where intense emotions
run high, materials, sounds, smells, light, and
colour have an enormous influence on how
people perceive themselves and cope with
their situations. In hospital healing spaces,
the patient’s experience is often undervalued,
overlooked by the functions and operations
of the medical treatments and busy schedules.
The human body has an incredible ability to

“self-heal” when put into positive healing
environments. This healing is enabled
by the ability of the body to ‘tap into our
internal pharmacies’ by responding to the
spaces around them.2 One of the body’s
most effective ways of healing is through
means of releasing chemicals in the brain
such as endorphins (dopamine) which have
the ability to reduce pain and swelling, lead
to feelings of euphoria, modulate appetite,
and enhance the immune response. Certain
elements in environments such as colour,
light, and natural landscapes can contribute
to the body’s ability to self-heal. This can
2) Sternberg, Esther**, and Tippett, Krista. Esther Sternberg. The

science of healing places. In On Being [database online]. 2013
1) Zumthor, Peter*: Thinking Architecture, Boston: Basel, 1999. [cited Sept 17 2014]. Available from http://www.onbeing.org/
program/the-scienceofhealingplaces/4856/audio?embed=1.
*Peter Zumthor is a Swiss architect and winner of the 2009 Pritzker
Prize and 2013 RIBA Royal Gold Medal. **Esther Sternberg is an expert in neural-immune science.
3
increase one’s chances of healing faster. STRESS threatened may actually have more to do with spirit) simultaneously. This approach views
Many contemporary healing spaces have Stress is often a large hurdle to handle one’s state of mind on the situation more than the patient as a whole person, not limiting
become so function-oriented that they lack when coping with a life threatening disease the triggering of the event itself.7 The body healing methods to only the physical
many of these aspects in their design. The such as cancer. Stress is defined as the wear has natural abilities reduce stress through the conditions. Brain pharmaceuticals have the
following thesis focuses on cancer patients and tear on the body as it tries to deal with means of brain pharmaceuticals. ability to help rehabilitate a patient’s physical
and the specific challenges they face from the environmental stressors. The initial phase of and emotional health.
built environment while in treatment and how a stress reaction is the alarm reaction. This is BRAIN PHARMACEUTICALS
architecture can help augment their healing. where the body begins to gather its defense One of the body’s most effective ways ENVIRONMENTS OF HEALING
mechanisms. The body typically experiences of healing is through means of releasing The placebo effect is known as a “fake
HEAL VS. CURE a stress reaction, essentially shutting down chemicals in the brain such as endorphins treatment” that does not hold any active
There is a distinction between the terms any systems that are not essential in the “fight- (dopamine) which have the ability to substances itself. It helps the body heal
“heal” and “cure” although the two terms are or-flight” mode and debilitates the immune reduce pain and swelling, lead to feelings simply by the mind’s expectation that it will
often used interchangeably. Healing refers system by releasing stress hormones.5 of euphoria, modulate appetite, and enhance heal, and the brain then releases endorphins.
to alleviating a person’s distress or anguish. Long-term exposure to stress reduces the the immune response. Endorphins are natural Placebos can ultimately reduce swelling
Curing is the relief of the symptoms of a body’s ability to fight diseases, infections, and not addictive, unlike many drugs, and and pain, minimizing stress, which makes
disease or condition. Healing encompasses and mental illnesses such as depression. often have the same effect as traditional the body better able to receive medical
alleviating emotional stress, improving the Hormones released during stress also directly drugs such as morphine and codeine. treatments. Charles Jencks, designer of the
ability to cope and establishing a positive take part in the development of degenerative These chemicals can be considered “brain Maggie’s Centres (see Fig. 1.1) believes
state of mind. One can heal without being diseases such as brain hemorrhages, kidney pharmaceuticals,” an integral part of the in the architectural placebo effect, and
cured, which is to say one can move through failure, peptic ulcers, and cancer, among body’s internal pharmacies.8 Stress is the through his work shows the importance of
a healing process while still being affected by others. Often people will experience a stress body’s biggest obstacle in terms of healing environments of healing. Architecture has
a disease. Healing may include acceptance by reaction where their body is weakened due and brain pharmaceuticals can reduce stress, the power to indirectly boost the immune
coming to terms with a life you may soon be to their body operating in a fight-or-flight making healing more manageable. Holistic system.9 He used this philosophy to guide
leaving.3 “Healing may not be so much about mode, but this can be avoided by coping with healing encompasses care of the mind and his design of the Maggie’s Centres, a series
getting better, as about letting go of everything stress in a positive way by having a stress body which is crucial for optimal healing. of retreat centres for people dealing with
that isn’t you – all of the expectations, response instead of a stress reaction. A stress cancer. There, people receive practical and
all of the beliefs – and becoming who you response is an adaptive, healthy set of coping HOLISTIC HEALING social support for dealing with cancer in an
are. Not a better you, but a realer you.”4 In strategies. This will help one steer away from Patients are often treated as the site of an environment that supports their emotional
terms of the healing of patients affected by automatic reactions and maladaptive coping illness, and the person’s emotional health is needs. William James, an American
cancer, architecture is an element with great strategies.6 This is especially important for not taken into consideration. The description philosopher and psychologist, believed “the
potential to augment healing through the built patients dealing with a disease like cancer of a person with an illness goes further to greatest revolution in our generation is the
environment. which requires long-term treatment and represent the person as a whole who is going discovery that human beings, by changing
recovery. Many people go to hospitals with through an experience involving a disease. the inner attitudes of their minds, can change
extreme emotions such as fear, anxiety, Holistic healing encompasses healing of the outer aspects of their lives.”10
and frustration. In many cases, one feeling both the body and the mind (including the
7) Kabat¬Zinn, Jon. 1990. “On Healing.” Chap. 13, In Full

Catastrophe Living, 267. New York, NY: Dell Publishing. 9) Rose, Steve. “Maggie’s Centres: Can Architecture Cure Cancer?”
5) Malkin, Jain. 1992. Creating a healing environment. In Hospital 8) Sternberg, Esther, and Tippett, Krista. Esther Sternberg. The The Guardian, accessed June 20, 2015, http://www.theguardian.
3) Moyers, Bill. 1993. “Wounded Healers.” Parabola, the Magazine Interior Architecture., 13-17. science of healing places. In On Being [database online]. 2013 com/artanddesign/2010/may/06/maggiescentrescancerarchitecture.
of Myth and Tradition, 22. 6) Kabat¬Zinn, Jon. 1990. “On Healing.” Chap. 13, In Full [cited Sept 17 2014]. Available from http://www.onbeing.org/ 10) Levitt, Andrew. 2015. The Inner Studio. A Designers Guide to
4) Ibid. Page 28. Catastrophe Living, 264. New York, NY: Dell Publishing. program/the-scienceofhealingplaces/4856/audio?embed=1. the Resources of the Psyche. Arch 641 Lecture.
4 5
of the biggest obstacles to overcome while “If a work of architecture consists of forms
undergoing chemotherapy. There is much and contents which combine to create a
anxiety and fear associated with the diagnosis strong fundamental mood that is powerful
of cancer, and often treatment plans are enough to affect us, it may possess the
unclear and uncertain of the outcome. Cancer qualities of a work of art. This art has,
patients tend to spend a lot of time at the however, nothing to do with interesting
hospital for different treatments, procedures, configurations or originality. It is concerned
and tests. The environments in which they are with insights and understandings, and above
placed greatly affect their healing potential. all with truth.”13
In order to realistically move towards fully

realized wellness, hospitals need to take a
holistic approach to treat a patient’s physical
illnesses, psychological health, emotional
hardships, and physiological responses
by considering the environments patients
inhabit. Medical treatments and procedures
need to operate in union with architecture;
both have a vast impact on a patient’s
treatment and recovery of the mind and
body. Healing is separate from the cure of an
FIG. 1.1. The first Maggie’s Centre was built in Edinburgh and opened in 1996, designed by Charles illness; it is important to recognize the value
Jencks. of healing and coping with stress in a positive
way. The power of the mind has an incredible
influence on one’s ability to heal. Therefore,
POWER OF NATURAL LANDSCAPES viewed a brick wall.12 Plants and elements of hospitals must leverage the healing
Natural landscapes play an enormous role in nature represent healing, growth, and hope. possibilities that architecture can contribute
the design of the Maggie’s Centres. Plants They offer an attitude of the mind. A plant can to the environment. This will help produce
and natural landscapes have shown to have be a representation of how we can feel and the most advantageous opportunities for
a powerful impact on people who are ill by how we can change how we see ourselves. creating healing spaces, pushing architecture
creating soothing healing environments. A to hold an active part in the healing process.
study performed by Roger Ulrich11 found that CANCER PATIENTS
a view of a park outside a patient’s window Cancer patients bring very specific challenges
helped patients recover faster, requiring less to the hospital, such as severe fatigue, fear,
pain medication compared to patients who and emotional vulnerability. Fatigue is one
11) Roger Ulrich was the co-founding Director at the Centre for 12) Ulrich, Roger S. Effects of Healthcare Environmental Design
Health Systems and Design at Texas A&M University. on Medical Outcomes. 13) Zumthor, Peter: Thinking Architecture, Boston: Basel, 1999
6 7
THESIS STRUCTURE
PART I: INTRODUCTION colour, light, views, scents, etc. This part also for cancer patients: the chemotherapy suite
Healing through Architecture explores explores the importance of holistic healing; at Grand River Regional Cancer Centre.
how the architecture of a healing space can treating the patient as a whole person, and not The design proposals aim to test a variety of
become an integral part of healing itself and as the site of a disease. By stimulating certain strategies to address these questions:
how it can have an active role in the healing brain pharmaceuticals, the power of the mind • How can architecture of a healing space
process. Part I introduces the terms of healing has much potential in healing. become an integral part of healing itself?
and curing and defines the critical differences • How can architecture have an active role
for setting up a framework to consider the PART IV: HEALING ENVIRONMENTS in the healing process?
following research. This thesis focuses on Hospital environments play a crucial
healing, recognizing the differing roles and part in one’s healing. Part IV compares PART VII: DESIGN DEVELOPMENT
potentials between medical doctors and traditional hospitals built in the 1800’s with After examining many types of healing
architecture. contemporary hospitals built Post-WWII spaces and the site of intervention, this final
and examines why a shift in design approach part explores the design development and
PART II: STRESS took place. Traditional hospitals typically intervention proposals which aim to address
Part II defines what stress is and examines had a high emphasis on incorporating the challenges of the chemotherapy suite,
what it specifically does to the body. This part natural healing into their designs, while discussed in Part V and VI. The designs seek to
addresses when and why a stress reaction contemporary hospitals are generally more help augment healing through environmental
takes place and why it is important to take function-oriented. Holistic healing is further elements, by supporting the body’s natural
preventative measures to prevent this stress discussed regarding the potential placebo abilities to release immune-boosting brain
reaction and channel a more positive and effect relating to natural landscapes. pharmaceuticals. Assessments are conducted
more productive stress response. to evaluate the success of the designs,
PART V: CANCER PATIENT including their strengths and weaknesses.
PARTIII:BRAIN PHARMACEUTICALS So far the thesis has discussed the effects Additional spaces outside the chemotherapy
Part III examines the different brain of stress, the role of brain pharmaceuticals, suite are also examined to explore how these
pharmaceuticals the body uses when the importance of holistic healing, and the design systems can be integrated throughout
responding to different environmental role environments play in holistic healing. a hospital.
conditions, including stressful ones. Here, Part V reviews the focus patient undergoing
the thesis examines some key precedent chemotherapy and investigates the specific
projects to demonstrate the effects of different challenges one faces with cancer treatment.
elements on the body, including Spilt Time
Café (Philip Rahm) and the Japanese concept PART VI: DESIGN SITE
of Forest Bathing (Shinrin Yoku). The The thesis has reviewed a variety of healing
research presents the major influences that spaces, many of which showed positive
environmental elements can have on one’s health impacts. Part VI now presents the
body and one’s psychological state, including space where the design proposals take place
8 9
PART II: EFFECTS OF STRESS
Effects of stress on the body
11
STRESS
A visit to the hospital could be more Stress puts the body into a “fight-or-flight” COPING WITH STRESS THE WANDERING MIND
frightening than the ailment that brought one mode, shutting off all systems unnecessary One will often experience a stress reaction Living in the moment is crucial in order
there to begin with. This has a lot to do with for the immediate potential danger. where the body is weakened from operating in to fully cope with stress. It has been found
stress. a fight-or-flight mode, but this can be avoided through a study done at Harvard University
The initial phase of a stress reaction is the by coping with stress in a positive way by in 2010 by Killingsworth and Gilbert that
“People go to hospital in the hope of feeling alarm reaction where the body gathers its having a stress response instead of a stress people who are depressed live in the past,
better. But if patients are welcomed into a defense mechanisms. Next, the body either reaction. A stress response is an adaptive, thinking about what has already happened.8
forbidding, institutional room with a strange experiences resistance or adaptation to healthy set of coping strategies. Mindfulness Anxious people live in the future worrying
bed, fluorescent lights and cold hard floor, the situation and after some time the body is one of the positive ways to recognize about what may happen. The happiest people
what then?”1 asks Michael Swan of The experiences exhaustion as it wears down2 moment-to-moment awareness of oneself and live in the current moment. It is estimated
Catholic Register. Hospitals tend to do a very (see Ill. 2.1). one’s reactions to help maintain control on the that 47% of our time is not spent in the
good job of making people feel worse before flow of events that happen within the body present.9 “A human mind is a wandering
they feel better. Stress reaches two biological systems: during stress. This will help one steer away mind, and a wandering mind is an unhappy
the endocrine and the nervous systems. from automatic reactions and maladaptive mind. The ability to think about what is
Many healthcare facilities inflict high levels When under stress the body releases coping strategies.3 Having mindful awareness not happening is a cognitive achievement
of stress on patients, visitors, and staff adrenocorticotropic hormone (ACTH), a is the start of gaining control of the situation. that comes at an emotional cost.”10 Patients
members. What exactly is stress and why stress hormone, which stimulates the adrenal By the mind being conscious in the present, receiving chemotherapy often live in the past,
does it happen? Stress can be one of the cortex to kill white blood cells which control one is better able to recognize the thoughts, worrying about recent diagnosis and news
most aggregating factors when people are allergic reactions and hypersensitivity. feelings, and sensations being experienced. on their treatments. They also live in the
dealing with illnesses. Stress is not so much Essentially, stress debilitates the immune Such self-awareness can result in inner future worrying about upcoming treatments,
an external factor, but rather it refers to the system. Long-term exposure to stress reduces calmness, acceptance, and openness. In possible symptoms, and potential negative
wear and tear on the body as it attempts to the body’s ability to fight diseases, infections, many cases, one feeling threatened may outcomes. Some of the common worries of
deal with environmental stressors. and mental illnesses such as depression. actually have more to do with one’s state of chemotherapy patients include those about
Hormones released during stress also directly mind about the situation than the triggering money and possible time off work to attend
take part in the development of degenerative of the event itself.4 Jain Malkin5 argues that it hospital appointments. They worry about
alarm reaction
conditions and diseases including: is absolutely necessary to treat the mind and how to get home and what to make for
(body gathers defense mechanisms) body simultaneously, as they both directly dinner that night, new medications and how
• brain hemorrhage affect each other.6 they will feel after taking them, and what to
• hardening of arteries do if something goes wrong at home or at
„
resistance or adaptation • coronary thrombosis the hospital. In order to eliminate most of
“
• kidney failure this anguish, it is important that they avoid
• peptic ulcers worrying about things they cannot control,
Stress exacerbates every
• arthritis but rather think in the present moment to help
exhaustion known clinical condition7
• cancer with relaxation, cultivate mindfulness, and
encourage happiness.
ILL. 2.1. Alarm Reaction - Roger Ulrich
4) Ibid. Page 267.

5) Jain Malkin is the President of Jain Malkin Inc. and author of
Hospital Interior Architecture. 8) Levitt, Andrew. 2015. The Inner Studio. A Designers Guide to the
6) Malkin, Jain. 1992. Creating a Healing Environment. In Hospital Resources of the Psyche. Arch 641 Lecture.
2) Malkin, Jain. 1992. Creating a Healing Environment. In Hospital Interior Architecture., 13-17. 9) Ibid.
Interior Architecture., 13-17. 7) Hamilton, Kirk. 2010. “Role of Design in Creating Therapeutic 10) “Mind is a Frequent, but Not Happy Wanderer: People spend
1) Swan, Michael. 2015. “Bringing the Human Back into Hospital 3) Kabat¬Zinn, Jon. 1990. “On Healing.” Chap. 13, In Full Environments.” Chap. 10.4, In Design for Critical Care, 251. nearly half their waking hours thinking about what isn’t going on
Design.” Catholic Register, 14 June 2015, 16. Catastrophe Living, 264. New York, NY: Dell Publishing. Burlington, MA: Elsevier Ltd. around them.” 2010.
12 13
POORLY DESIGNED SPACES
IMPORTANCE OF DESIGNING WITH hand, like many other patients, was tired, were hardly any more pleasures in life left to
THE PATIENT IN MIND weak, and anxious. A large busy atrium was enjoy. Remembering how much she longed
Happiness requires a particular state of mind. the last place she felt like spending time in. to be outdoors herself while in the hospital,
Stress has an enormous impact on happiness With so many radiation oncology machines, Holtzman would take her mother for a walk
and one’s ability to heal and stay positive. there were close to 50 people waiting in the everyday, and, although her Mom couldn’t
The design of a healthcare facility is not atrium at one time, in addition to all the staff even remember who she was, she was still
only important for function and efficiency, and others using that space to walk from one able to appreciate the sun and fresh air.13
but also has a vast impact on patients’ well- end of the hospital to the other. The Druxy’s
being and ability to cope with stress. Many Deli is also located in the atrium, bringing When Holtzman asked the nursing home
times patients walking into hospitals become people with lots of conversation to the already staff about the home’s green space, she was
stressed due to the stark-bright, white lights, loud environment. Despite my positive first told that staff were too busy to take residents
cold floors, and hard walls along with the FIG. 2.1. Canadian emergency waiting rooms impression of the space, my Mom said she outside. Knowing the positive impact a walk
become uncomfortable and crowded.
confusing way-finding. always “felt like a number, as though I am on had on her mother, Holtzman volunteered to
an assembly line with no personal care.” take other patients for walks in the green space.
Sarah Tan explains her experience Often, large hospitals will be programmed Holtzman describes her observations as she
accompanying her mother to her first like a well-tuned machine in terms of how OUTDOOR SPACES watched the nursing home residents explore
oncology appointment. “Moving from room they register, process, and treat people. Author Liliana Holtzman writes in her blog the outdoors. “I will never forget as men and
to room in the building was confusing, and Registration staff, nurses, and doctors see so about the importance of having outdoor women slowly ventured outside through that
long waiting periods weren’t alleviated many people on a daily basis that the special healing spaces in addition to soothing, indoor open door. Alzheimer’s Disease robs patients
by soulless and crowded waiting areas” attention and care for each individual patient healing spaces: “After my treatments and of smiling and displays of emotion but these
she describes. “Every time I go, I feel sick is lost, which is what people so desperately surgeries for breast cancer I spent a lot of time people demonstrated their joy in other ways.
myself.”11 crave, especially in a time of dire need. in a hospital. Lying in an ugly, impersonal, Some walked around in wonder, stepping on
noisy room I longed for beauty, color, quiet. shadows or looking at the sunlight. Some sat
It’s no wonder that people feel more sick My mother, Sue Beggs, was treated at the But more than anything else, I longed for on the ground, delicately caressing blades
the longer they spend in these depressing Odette Cancer Centre at Sunnybrook Hospital fresh air. The hospital had no balconies, of grass. Some held hands. Everyone was
environments (see Fig. 2.1). When there is for approximately seven weeks in 2013. gardens or outdoor spaces. I lay in my room quiet.” Holtzman was later told by the nurses
a lack of humble, human interactions and While I was impressed with the large triple- looking at a closed window with a view of the that it was the quietest night the home had
spaces to facilitate this energy, staff, doctors, height atrium waiting space and the bright parking lot imagining that I was sitting on a seen in a very long time. “Tired out from
patients, and visitors all become less able to light that shone through the south-facing shady bench in a pretty garden.”12 Holtzman walking and breathing fresh air, the patients
cope properly with the stress they experience glazing, my Mom felt very differently about describes how outdoor healing spaces slept peacefully through the night” Holtzman
in these spaces. This is completely counter- that space. I, as a healthy visitor supporting impacted her mother who faced Alzheimer’s related.14 Relaxing the mind is important for
intuitive to the whole purpose of a hospital, my Mom, was reminded of a large shopping Disease while in a nursing home. Battling the patients’ well-being and good health.
which is to help people who are ill, feel better. mall in the way the space was designed. To disease, her mother didn’t know who she was
What hospitals tend to do is make people feel me, this was relaxing and comforting. But I and didn’t recognize family members. With
a lot worse before they feel better. was not the patient. My Mom, on the other her disease getting progressively worse, there
11) Ong, Iliyas. “Healing Spaces.” Going Places., accessed 12) Holtzman, Liliana. "Healing Spaces." Gracious Living, Day
May 2, 2015, http://www.goingplacessingapore.sg/design/2014/ by Day., accessed 4 May, 2015, http://graciouslivingdaybyday. 13) Ibid.
HealingSpaces.aspx. com/2013/01/14/calmspaces/. 14) Ibid.
14 15
LIMITS TO MEDICINE
DEFINITION OF HEALTH “PREGNANT IN AMERICA”

“Health is a state of complete physical, DOCUMENTARY19 (SUMMARY)
mental and social well-being, and not merely In an online documentary filmed in the
the absence of disease or infirmity.”15 At the United States in 2008, married and expecting
stress reduction clinic at the University of couple Steve and Mandy Buonaugurio
Massachusetts Medical Center, healing is explore the benefits and risks of giving birth
described as the experience of undergoing at home rather than in a hospital. Although
a profound transformation of view. Healing the norm today in the U.S. is to give birth at
creates a sense of control over a situation a hospital, they discover that the hospital’s
from feeling helpless and pessimistic to way of moving a woman through childbirth FIG. 2.2. Woman demonstrating different FIG. 2.3. Woman demonstrating different
a sense of acceptance and inner peace. in several ways goes against the natural positions women can choose to use while positions women can choose to use while
“Healing is always a unique and deeply process. They visited The Netherlands which giving birth to suit their own comfort in giving birth to suit their own comfort in
personal experience.”16 has the highest home-birth rate in the western Germany. This physically and psychologically Germany. This physically and psychologically
helps the mother through a comfortable helps the mother through a comfortable
world and interviewed women about their birthing process. birthing process.
IATROGENIC DISEASES experience with home births.
Iatrogenic diseases, illnesses caused by a need space with air and light, and there are The mother and baby are meant to work
medication or physician, are of growing Hospitals tend to induce more stress in other women who want it nice and cozy. If together during childbirth, yet the epidural
concern. “Medicalization frequently causes mothers, which can be dangerous for both you let a woman move the way she feels like drug impairs both parties. Dr. Michel Odent
more harm than good.”17 The number of mother and baby. Hospitals also contain a it (sic) she will find the position for herself explains that, while giving birth, women are
deaths caused from iatrogenic illnesses top lot of air-bourne illnesses and bacteria. The that hurts her less and where she feels the meant to release a natural, yet complex, flow
deaths caused from heart disease and cancer. home is very calming; the family knows baby moving well” says the Director of the of hormones, the main one being oxytocin as
Over a 10-year project, numbers of deaths of where everything is and has comforting Women’s Birth Center at Burger Hospital well as endorphins. Immediately following
iatrogenic illnesses (7.8 million) will surpass personal belongings around them. Giving in Frankfurt, Germany. The typical North the birth, the mother experiences a rush of
the number of American soldier deaths.18 birth at home also allows the mother to American birthing position of a woman lying oxytocin, which is critical for the mother-
Medicine causes the most illnesses through: choose the position and location in which she on her back with her legs bent up to her arms baby bond. The epidural not only limits this
• medical technology would like to give birth. It puts the mother creates a sharp turn for the baby to make effect but also has many negative health risks
• diagnostic testing in control of her own child’s birth. Some around the pelvic bone. This can create more associated with it and has been linked to
• overuse of medical procedures women choose birthing pools, or to sit, or to pain, stress, and possible complications for teenage drug use and suicide.
• overuse of pharmaceutical drugs lie down. Many North American hospitals the mother and baby.
on the other hand are very inflexible with the It is through physical comfort and having
Patients need hospital environments to work way they allow mothers to give birth; they are North American hospitals are also known considerable control that mothers have the
with their individual needs when they are designed to make the doctors’ work easier. In for their heavy use of pain medications for most comfortable birth possible. Hospitals
sick to maximize healing potential. Pregnant Germany, birthing centres offer many options child birth, specifically the epidural. The can feel more like home by incorporating
woman have similar needs when it comes to for mothers to give birth (see Fig 2.2 & 2.3). typical debate is when a woman should get these concepts into their designs.
personalized care during childbirth. “Some women like to be in a wide room, they her epidural, rather than if she will get one.
15) Awofeso, Niyi. “ReDefining ‘Health’.” World Health

Organization. WHO, accessed 06 June, 2015, http://www.who.int/
bulletin/bulletin_board/83/ustun11051/en/.
16) Kabat¬Zinn, Jon. 1990. “On Healing.” Chap. 13, In Full
Catastrophe Living, 168. New York, NY: Dell Publishing.
17) Riversong, Robert. Death by medicine. [cited Nov 1 2014]. 19) Pregnant in America. YouTube. Directed by Steve Buonaugurio
Available from http://riversong.wordpress.com/deathbymedicine/ and Mandy Buonaugurio. 2008. Accessed 03 November 2014,
18) Ibid. https://www.youtube.com/watch?v=yEcYSMmJrw8.
16 17
REDUCING STRESS IN HEALING SPACES
THEORY OF SUPPORTIVE DESIGN VIEW THROUGH A WINDOW MAY VIEWS OF NATURE

Fostering comfort and control reduces stress, a INFLUENCE RECOVERY FROM Dr. Roger S. Ulrich was a very influential
critical factor in healing spaces because stress SURGERY figure in the movement to research the
has a variety of detrimental psychological, Dr. Roger S. Ulrich performed a very environment of healing spaces. Many other
physical, and behavioural effects.20 Dr. influential study in 198421 that examined the studies have also found that “seeing nature”
Roger S. Ulrich has done extensive research recovery outcomes between patient groups helps to decrease the number and severity of
on the importance of eliminating stress in recovering from gall bladder surgery (see negative health conditions. “Reducing stress,
healing spaces and argues the importance of Ill. 2.2). Half of the group had a view of a and distracting patients from their internal
eliminating stress in order to improve health park outside their window, and the other half focus or their obsession on their own pain,
outcomes. He developed guidelines for saw a brick wall. The view of a park had very reduces the pain,” says Ulrich.23
improving health environments in his Theory 7.96 days in hospital positive effects on the patients. They showed
of Supportive Design (below). the need for less pain medication; they had This result was shown in an experiment where
1.13% neg. nurse notes less negative nurses’ notes and, on average, post-heart surgery patients were bedridden
1 - FOSTER CONTROL, INCLUDING were discharged a day sooner than the group and showed positive results when they viewed
Less strong pain medications
PRIVACY with a brick wall outside their window. coloured pictures. Those patients who had an
Providing actual or perceived control over Viewing plants had a big influence on the image of a nature scene with trees and water
stressors can help alleviate stress, including body’s healing process. needed less pain medication compared to the
giving a patient control over light dimmers patients who viewed an abstract image, or no
and privacy, providing personal choice of HEALTH BENEFITS IN BETTER image at all.24
music, control over TV, and easy way-finding HOSPITAL DESIGN
signs. 75% patient falls
It is extremely important to reduce stressful
conditions in hospitals in order to help reduce
2 - PROMOTE SOCIAL SUPPORT 30% errors patient stress and promote sleep. Lack of
Studies show that social support helps 11% hospital infections good quality sleep has been shown to cause
mitigate stress and improve recovery rates. To increased stress, impaired immune function,
encourage the presence of family and friends, 16% medication use and difficulties with temperature regulation.25
8.70 days in hospital
hospitals can offer plenty of comfortable 95% patient satisfaction
seating, access to food, telephones, overnight 3.96% neg. nurse notes Stress reduction not only improves the
Nurse turnover
accommodations, and internet access. patients’ well-being, but also the staff’s
More strong pain medications Staff satisfaction ability to handle stresses of work and even
3 - PROVIDE ACCESS TO NATURE sleep better when they are home (see Ill. 2.3).
$12 million more spent on upfront costs
Studies have shown that viewing certain recovered within 1 year of operation22 “Less noise and better-lit environments also
types of nature can significantly relieve stress, reduce clinician error.”26
within five minutes or less, by lowering blood ILL. 2.2. View through a window may influence ILL. 2.3. Robert Wood Johnson Foundation
recovery from surgery [1984 study of patients report (2003) shows the benefits of “Better
pressure and reducing heart rates.
recovering from gall bladder surgery]. Hospital Design.”
23) Maddox, Lucy. “Can the Design of Hospitals Help Patients

21) Ulirch, Roger S. Effects of Healthcare Environmental Design Recover Faster?” Gizmodo., last modified 25 November,
on Medical Outcomes. accessed 09 December, 2014, http://gizmodo.com/canthedesignof-
22) Sternberg, Esther, and Tippett, Krista. Esther sternberg the hospitalshelppatientsrecoverfaste-1663083331.
science of healing places. in On Being [database online]. 2013 [cited 24) Ibid.
20) Ulirch, Roger S. Effects of Healthcare Environmental Design Sept 17 2014]. Available from http://www.onbeing.org/program/ 25) Ibid.
on Medical Outcomes. thescienceofhealingplaces/4856/audio?embed=1. 26) Ibid.
18 19
Part II examined stress and the harm it does to
the immune system, making healing difficult.
Stress reactions are negative ways for the
body to deal with stress and damages physical,
mental, and emotional health, and ultimately
affects a patient’s well-being. It is important to
take preventative measures to avoid negative
stress reactions and channel a more positive
and more productive stress response. Stress
is a common problem for patients visiting the
hospital and many modern hospitals built after
World War II are not always the most ideal
spaces for healing. Two key studies including
Ivan Illich’s writings and the Pregnant in
America documentary describe how stressful
environments can create many medical
complications. Strategies for reducing stress
in healing spaces include the incorporation
of nature by means of physical plants and
views of parks from windows. A key study by
Roger Ulrich discovered the overwhelming
positive effects of viewing a park from a
hospital patient room. Another study by the
Robert Wood Johnson Foundation revealed
many health benefits in better hospital design
for user well-being, as well as economic
advantages.
Part III examines the different brain

pharmaceuticals the body uses when
responding to different environmental
conditions, including stress, and reviews
several precedent projects both experimental
and medical in nature.
21
PART III: BRAIN PHARMACEUTICALS
Investigating the body’s own processes of healing
23
BRAIN PHARMACEUTICALS
Numerous studies show much evidence of the

body’s ability to “self-heal” through its ability
to ‘tap into our internal pharmacies’.1 One of
the body’s most effective ways of healing
is through means of releasing chemicals Hearing Touch
in the brain, brain pharmaceuticals, such TOUCH
as endorphins (dopamine) which can help ILL. 3.2. Passive (left) vs. Active (right) stress
manage pain and swelling, promote feelings coping strategies HEAR
of euphoria, modulate appetite, and boost the
immune response. Endorphins are natural PASSIVE VS. ACTIVE COPING
and not addictive, unlike many drugs, and STRATEGIES
often have the same effect as traditional There are two main types of strategies for
drugs such as morphine and codeine. These coping with stress: passive and active. They
chemicals are an integral part of the body’s work in different ways, both ultimately trying
to decrease the stress the body experiences Sight
internal pharmacies. Smell
(see Ill. 3.2). The design development of this
HOLISTIC HEALING thesis focuses on more active strategies. SMELL
Holistic medicine is a form of healing that SIGHT
considers the whole person -- body, mind, Passive strategies eliminate environmental
spirit, and emotions -- in the quest for optimal stressors to minimize the body’s stress
health and wellness2 (see Ill. 3.1). Holistic response which often debilitates the immune
PITUITARY GLAND
healing, for example, includes physical system and ultimately makes treatments Endorphins
Endorphins and Melatonin released here
treatments alongside emotional support. harder for the body to accept.
Active strategies introduce psychological

ILL. 3.3. Brain Pharmaceuticals
and sensory interventions to manipulate the
mind and body’s ways of perceiving and
responding to environmental conditions. HEALING THROUGH THE SENSES They react similarly to drugs such as morphine
“
Brain pharmaceuticals react to stimulations and codeine (without the addiction). They
„
MIND BODY from different senses (see Ill. 3.3). The brain also lead to feelings of euphoria, modulate
Ultimately it is the senses that will respond to environmental relaxers or appetite, release sex hormones, and enhance
need to be revitalized as it is an stressors and release chemicals in the brain immune response.4 Melatonin is a hormone
integral part of healing.3 that respond to the appropriate situation. associated with the onset of sleep. Its release
Endorphins interact with opiate receptors of is often triggered by dense light wavelengths
ILL. 3.1. Holistic Healing - Nancy Singh the brain to reduce our perception of pain. of such colours as yellow and orange.
2) “What is Holistic Medicine?” WebMD., accessed Dec 10, 2014,

1) Sternberg, Esther and Tippett, Krista. “Esther Sternberg - the http://www.webmd.com/balance/guide/what-is-holistic-medicine.
Science of Healing Places.” On Being, last modified 2013, accessed 3) “Grandnm”. “Healing Architecture.” Scribd., last modified 4) Stoppler, Melissa C. and Shiel, William C. “Endorphins: Natural
Sept 17, 2014,http://www.onbeing.org/program/the-science-of- Apr 8, 2014, accessed Sept 24, 2014, http://www.scribd.com/ Pain and Stress Fighters.” MedicineNet.com., accessed Oct 10, 2014,
healing-places/4856/audio?embed=1. doc/216951537/HealingArchitecture. http://www.medicinenet.com/script/main/art.asp?articlekey=55001.
24 25
PROMOTING CALMING The adrenal gland controls the release of
Esther Sternberg explains the importance cortisol, a stress hormone that places the
of an environment’s ability to promote a body into the fight-or-flight mode, mentioned
calming effect. It is vital that patients are as previously in Part II.
calm as possible when in a healing state so
that their body’s stress response isn’t fighting The vagus nerve responds to the body’s stress
the medical treatments. The body and the reaction and carries a wide assortment of
doctor’s interventions must work together signals to and from the brain. It is responsible
PITUITARY GLAND to maximize healing potential. When an for a number of instinctive responses in the
(ACTH & Endorphins released here) environment is able to keep a patient calm, body such as heart rate and breathing (see Ill.
it lowers the body’s stress response, and the 3.5). A stress reaction can result in variable
vagus nerve, which carries a wide variety of blood pressure, irregular heart beat, and heavy
ILL. 3.4. Pituitary Gland in Brain signals from the brain to multiple organs, is breathing, among other negative effects.6
able to improve systems in the body, such as
heart rate variability, breathing, blood flow, SUBCONSCIOUS HEALING
etc., to improve recovery outcomes. By stimulating the release of endorphins,
the body is able to reduce the perception
TYPES OF BRAIN of pain and strengthen the immune system,
PHARMACEUTICALS aiding in the healing process without the use
VAGUS NERVE Endorphins are natural chemicals in the brain of potentially addictive drugs with possible
(Controls various systems)
released in the pituitary gland (see Ill. 3.4) negative side effects.
that reduce the perception of pain and lead
Lung
to feelings of euphoria. Endorphins boost the
Heart immune response making them very powerful
“Brain Pharmaceuticals” that often have the
Liver
Spleen
same affect on the body as morphine and
codeine without the dangerous side effects.5
ADRENAL GLAND
Gallbladder
(Cortisol released here) Adrenocorticotropic hormone (ACTH) and
Stomach cortisol are both stress hormones released
Kidney
when the body experiences a stress reaction.
Small intestine
They tell the body to debilitate the immune
Colon
system in order to focus on the immediate
danger.
ILL. 3.5. Vagus Nerve
5) Stoppler, Melissa C. and Shiel, William C. “Endorphins: Natural 6) “What is the Vagus Nerve?” wiseGEEK, accessed Oct
Pain and Stress Fighters.” MedicineNet.com., accessed Oct 10, 2014, 15, 2014, http://www.wisegeek.org/what-is-the-vagus-nerve.
http://www.medicinenet.com/script/main/art.asp?articlekey=55001. htm#didyouknowout.
26 27
TRADITIONAL DRUGS VS. “BRAIN PHARMACEUTICALS”
There are significant differences between of pain management but they have many Brain Pharmaceuticals are natural chemicals environments that stimulate these chemicals
traditional drugs and brain pharmaceuticals. dangerous risks associated with their use, in the brain with the potential to have the same through the use of brain pharmaceuticals.
Traditional drugs are used to manipulate particularly if used long term or in high doses effect as traditional drugs, with additional
chemicals in the brain, including the control (see Ill. 3.6). healthy benefits. The thesis aims to study
Traditional drugs often have

Used to treat mild to moderately severe pain many risks associated with their
CODEINE but can become addictive with long term use. use, particularly if used long
Abuse causes harmful side effects, including term or in high doses. In addition
loss of motor & coordination skills. to the potential addiction which
often leads to drug abuse and
potential overdose, doctor
Traditional prescribed use also has the
Drugs following risks associated with
Used to treat moderate to severe pain.
many drugs, among others:
MORPHINE Morphine poses a high risk of addiction - the
average body becomes accustomed to the
• Confusion
drug and begins to crave the presence of
• Constipation
opiates within two weeks of use.
• Troubled breathing
• Fainting
• Racing heartbeat
• Weak pulse
• Vomiting
This hormone is associated with the onset of
MELATONIN sleep. When released, melatonin makes the
body feel tired. This chemical is used to tell Natural chemicals produced by
the body when it is time to sleep. Natural the body do not pose any issues
Chemicals of overdose or addiction, yet
they can have the same effect
as traditional drugs such as
Dopamine interacts with opiate receptors of (Brain morphine and codeine (without
DOPAMINE
the brain to reduce perception of pain. They Pharmaceuticals) addiction).
also lead to feelings of euphoria, modulate
(Endorphins) appetite, release sex hormones and enhance
immune response.7
ILL. 3.6. Traditional Drugs vs. Brain Pharmaceuticals
7) Stoppler, Melissa C. and Shiel, William C. “Endorphins: Natural

Pain and Stress Fighters.” MedicineNet.com.,
accessed Oct 10, 2014, http://www.medicinenet.com/script/main/
art.asp?articlekey=55001.
28 29
THE POWER OF THE MIND
and that it is okay for them to die. Death is them feel the most comfortable.
something that everyone will experience. It
is part of being human and there is no shame POWER OF THE MIND
in dying. Our modern focus has been on The study of psychoneuroimmunology,
extending life with advanced medications or PNI, suggests that the immune system
and procedures. This, in turn, prolongs the is regulated in part by the nervous system
suffering and people end up being sick for which allows the whole body to function
long periods of time at the end of their life.13 harmoniously as a unified system. There is
People may live longer, but is this lengthened an apparent connection between the brain,
FIG. 3.1. Commonweal Retreat Center, FIG. 3.2. Commonweal Retreat Center, suffering worth it? What kind of quality of the mind, and the immune system; thus,
Pacific House Kohler House
life is this? “Extending life isn’t the high goal, the mind has incredible power over the
The mind has incredible power to heal the & 3.2). At Commonweal there can be much because people can live miserable lives for immune system.18 It is extremely important
body. When the mind is relaxed, it influences laughter found in the hallways and rooms. long, long periods of time.”14 Rachel Naomi to have a positive attitude when you are ill
the different systems in the body related to “The laughter and the joy come mixed with Remen15 supports this statement, saying “of – you have cancer, cancer doesn’t have you.
brain pharmaceuticals. Support groups have very intense emotions of pain and sorrow and course you want to live as long as you can, A study conducted by Dr. Robert Ader and
incredible impacts on people and are used to anger.”10 The ability to express fear creates but don’t you want to live well?”16 Vertical Dr. Nicholas Cohen at Rochester University
control stress and anxiety without heavy use room for joy. In a study by Fredericton, gardens [as found in the Design Development Medical School studied the power of the mind
of traditional drugs. David Spiegel performed it was found that people need on average in Part VII] represent healing, growth, cycle with rats. They gave rats immunosuppressing
a study that found people who were part of a three positive experiences to survive each of life: trees lose their leaves, branches die, drugs (to lower the immune response), while
support group tended to live longer, in some negative thought.11 Considering how many but the bush as a whole continues thriving. exposing them to a sweetening chemical in
cases twice as long as other people not part ways there are in a hospital for a person It is natural for people to live, thrive, and their drinking water at the same time. After
of a support group. The conclusion was that who is ill to encounter fear, anxiety, shock, then let nature take its toll and put them to this simultaneous intervention of drugs, and
people supporting people did tremendous and discomfort, it is crucial to cultivate as rest. Everyone has a different view on death, sweetened drinking water, it was evident
things for the mind. “People just cared about many positive moments inside the hospital to however. “For some people it’s never okay to that their brain was conditioned to expect
people.” This study also supports the need make up for the negative ones. Many patients die. They want to go out fighting, and that’s the immune suppressing drugs when they
to have care-givers well cared for, because in the hospital are facing the possibility of how they go out. But other people want to also received the sweetened water. Their
they are the people in direct contact with the death which is often a taboo term. Instead of come to terms with death and perhaps see brain became so accustomed to this that
patients, and their mood has a phenomenal denying the truth, patients can embrace their it as a process that might be interesting to later when the rats were given the sweetened
impact on those around them.8 situation by focusing on living well, even experience.”17 No matter the perspective, drinking water without the drug, their bodies
through their suffering. many things are out of our control and still showed the signs of weakened immune
Commonweal Retreat Centre is a retreat people deal with situations, especially death functions; their immune system was actually
centre located just north of San Francisco, DEATH AND DYING WELL or the possibility of dying, very differently. affected by a psychological learning and
California, that offers integrative healing “One of the toxicities of our culture [is] that Architecture has the ability to speak to many reacted as though the drug had been present.19
programs for people with cancer, health it makes dying not okay.”12 At Commonweal people in many ways and allow each person
professionals, and the rest of us9 (see Fig. 3.1 people learn to come to terms with dying to create their own mind-space that makes
9) “Commonweal Retreat Center.” Commonweal., last modified Jun

1 2015, accessed Feb 5, 2015, http://www.commonweal.org/. 13) Killing, Alison. “There’s a Better Way to Die, and Architecture
10) Moyers, Bill. 1993. “Wounded Healers.” Parabola, the can Help.” TED. TEDGlobal 2014, last modified Oct 2014, accessed 16) Moyers, Bill. 1993. “Wounded Healers.” Parabola, the
Magazine of Myth and Tradition, 25. Dec 5, 2014,https://www.ted.com/talks/alison_killing_there_s_a_ Magazine of Myth and Tradition, 29.
11) Levitt, Andrew. 2015. The Inner Studio. A Designers Guide to better_way_to_die_and_architecture_can_help?language=en. 17) Ibid. Page 28.
the Resources of the Psyche. Vol. Arch 641 Lecture. 14) Moyers, Bill. 1993. “Wounded Healers.” Parabola, the 18) Kabat-Zinn, Jon. 1990. “On Healing.” Chap. 13, In Full
8) Moyers, Bill. 1993. “Wounded Healers.” Parabola, the Magazine 12) Moyers, Bill. 1993. “Wounded Healers.” Parabola, the Magazine of Myth and Tradition, 29. Catastrophe Living, 174. New York, NY: Dell Publishing.
of Myth and Tradition, 24. Magazine of Myth and Tradition, 27. 15) Rachel Naomi Remen is the Medical Director at Commonweal 19) Ibid. Page 175.
30 31
SUFFERING BEFORE DEATH empowering23 (see Fig. 3.4). Three elements
The way we suffer near the end of our of the residence were carefully designed
lives has changed dramatically in the past with the users in mind: monumental sliding
century. One hundred years ago, people windows, detachable planters and mobile
used to die of infections and diseases such awnings. The sliding windows were designed
as pneumonia that would kill one off very to allow them to be opened with minimal
fast. Life expectancy was much lower, and effort. Giving residents the ability to control
people tended to die at home, surrounded by their environment on their own is extremely
family. During a TED Talk in 2015 entitled empowering. They no longer have to rely
There’s a Better Way To Die, Alison Killing FIG. 3.3. Nursing Homes can be the most on someone else to help them. “Detailing FIG. 3.4. Senior Residence, Peter Zumthor
spoke about the way we die and how that has unforgiving places to cope. can directly empower and free a dignity for
changed over the past 100 years.20 Today, illnesses and most of this time is spent in those who must so consciously feel their patient is often unknown and treatments
advances in medical technology, including hospitals, hospices, and care homes (see Fig. weakness.”24 often get worse before they get better. “A
large, expensive imaging machines, and 3.3). Therefore, compared to the early 1900’s, diagnosis of cancer hits you like a punch in
larger medical teams have moved medicine we are gaining several years at the end of In Zumthor’s planning, he recognized the the stomach... Cancer does kill of course –
to central facilities that we now recognize as our lives, but many years are spent in pain, struggle that the elderly experience near but fear, compounded by ignorance and false
hospitals. The 20th Century saw the rise of with loss of independence, often leading to the end of their lives as they watch their knowledge – is a paralysing attack in its own
optimism as to what this new medical science depression. A longer life does not necessarily bodies deteriorate; they are losing their right.”27 Cancer is bound to deeply affect
could offer. The focus of medicine shifted mean a better life. As we watch this trend independence and are often too afraid to ask even the strongest people. Many different
from how people died to extending life. continue and more cases of chronic illnesses for help, fearing to admit their weaknesses emotions accompany patients, and few people
arise, the discussion of where and how we die and lack of ability to do things that once came truly understand the most painful struggles
Andre Picard21 feels strongly about the has never been more important. This is where so easily to them. To avoid embarrassment, of cancer patients. “It is a difficult journey
importance of doctors treating patients as architecture can fill some voids. “Where we many seniors often resort to silence. Coming to walk. Sometimes it is overwhelming;
people, rather than just treating the symptoms die is a key part of how we die,” says Killing. to terms with their mortality is often more sometimes filled with gratitude, sometimes
of their ailments. In his convocation speech than they can handle. “They find themselves filled with fear,” Sue Beggs said of her battle
to the graduating medical students he says: DETAILING TO EMPOWER having to come to terms with unachieved with breast cancer. Like the senior citizens
“We see death as a failure, instead of aspiring A deep understanding of users and users’ hopes, goals, aspirations they may have once in Zumthor’s Senior’s Residence, cancer
to make patients comfortable and at peace at specific needs is of utmost importance in had.”25 Architectural details can help these patients often must come to terms with losing
the end of their life.”22 We used to die very the success of a space that is able to respond frail individuals gain their dignity back. “The their grasp of control, facing the realization
quickly but now with medical advances, to the users on a deeply emotional level. In season of life for the elderly deserves to be that their future is very uncertain. Here, like
North Americans are dying more from chronic an essay by University Graduate student one of life, hope, humour and vision.”26 Zumthor’s Senior’s Residence, elements that
diseases; the two most common being cancer Timothy Wat entitled Homes for Senior restore one’s hope, one’s dignity, and one’s
and cardiovascular diseases. This means we Citizens, Wat reviews Peter Zumthor’s EMPOWERING CANCER PATIENTS strength could have an enormous impact
will likely have a slow, painful struggle near Senior’s Residence in Chur, Switzerland and Unlike many other diseases, cancer is often that only those who are struggling can fully
the end of our lives while we endure these the miniscule details that become extremely life-threatening, and the journey of a cancer appreciate.
20) Killing, Alison. “There’s a Better Way to Die, and Architecture

can Help.” TED. TEDGlobal 2014, last modified Oct 2014, accessed 22) Picard, Andre. “A Challenge for New Doctors: Focus on the 23) Wat, Timothy. 2014. “Moments of Spiritual Engagement in
Dec 5, 2014,https://www.ted.com/talks/alison_killing_there_s_a_ Patient, Not just the Symptoms.” The Globe and Mail. The Globe Architecture.” Masters of Architecture, University of Waterloo.
better_way_to_die_and_architecture_can_help?language=en. and Mail, last modified Jun 9 2015, accessed Jun 10, 2015, http:// 6-26.
21) Andre Picard is a Globe and Mail health reporter and columnist, www.theglobeandmail.com/life/health-and-fitness/health/a- 24) Ibid. Page 10.
who received an honourary doctorate from the University of challenge-for-new-doctors-focus-on-the-patient-not-just-the- 25) Ibid. Page 13. 27) Jencks, Maggie Keswick. 1995. A View from the Front Line:
Manitoba in 2015. symptoms/article24859080/. 26) Ibid. Page 6. Marcia Blakenham. 9.
32 33
FOUR SENSES, MINDMAP
The following Four Senses Mindmap explores

several projects and studies that demonstrate
bodily reactions and ways of responding to a
variety of sensorial conditions (see Ill. 3.7).
Organized into the senses that each project/
study triggers (seeing, hearing, touching,
smelling), the mindmap explores studies such
as the influence of colour on anxiety levels,
the role music plays on blood pressure, and
different scents that affect fatigue, among
others.
35
CONNECT THROUGH MUSIC PRECEDENTS TACTICS / STUDIES VIEW OF NATURE
JOYFUL VS. ANXIOUS 40
Music was shown to have a positive impact on View through a window
Average Anxiety
Listening to joyful patients with long-term illnesses such as heart MURALS COLOUR
music: average upper may influence recovery from
disease, cancer and repository conditions. Studies Murals = distraction to Effects of Colour 30
arm blood vessel surgery34
show music can lower heart rate, lower blood burn patients36 on Anxiety35
diameter increased by pressure and help relieve pain and anxiety30 Pain intensity &
26%28 Colour
quality decreased
Anxiety dropped
Rosemary produces 7.96 days in hospital
ALERT
beta brain waves which

demonstrate alterness31 1.13% neg. nurse notes
Rosemary
Diurnism Less strong pain meds
Lavender has sedative SEE
FATIGUE SEDATIVE
effects, slows reactions, HEAR

reduces attention and impairs Cathedral
working memory31 Lavender of the Holy
8.70 days in hospital
Cross, Boston
RHYTHMS 3.96% neg. nurse notes
FIGHT
Peppermint (and cinnamon) Slower rhythms More strong pain meds

both fight driving fatigue31 Peppermint deepen breathing
and slow heart
Jasmine has shown to have rate to sooth29
OF SPACE CALM
a calming effect on mice31

Jasmine
“LIKE A DRUG” Mazes
PERCEPTION
75% of claustrophobic “Smells Lifeways Centre vs.

volunteers felt better being in act on the Centre, England for Cancer
an elevator31 Labyrinths
Cucumber brain like a and Health,
drug”31 Copenhagen
When exposed to scent,
violent criminals were less Split
RELAX
aggressive, had fewer fights, Time Cafe

were calmer and needed Orange FIGHT DEPRESSION The
Harmonorium
fewer sedatives31
Smells make you Weather
well: TOUCH FOLIAGE Project,
IMMUNE REDUCE
Scent reduces systolic

Scents of plants, Study showed that Tate Modern Turbine
blood pressure by an average
BP
trees, herbs people experience an hall, London

of 3-5 points in volunteers Apple
BREATHING and fruits have unconscious calming
under stress31
Deep breathing reduces been used since reaction to touching a
BOOSTING
stress response by kicking in ancient times to plant. Metal Stimulus

Frankincense has immune SMELL FEEL REDUCE INFECTIONS
the vagus nerve to improve fight inflammation, caused a stress
boosting features32 Frankincense
heart rate variability and depression and reaction in human Copper Surfaces Reduce
blood flow32 induce sleep31 cerebral blood flow33 Infections
28) Seiler, Bill. “Joyful Music may Promote Heart Health.” UMM.
ILL. 3.7. Four Senses Mindmap
University of Maryland Medical Center, last modified Nov 11,
2008, accessed Sept 19, 2014, http://umm.edu/newsandevents/
newsreleases/2008/joyfulmusicmaypromotehearthealth. 31) Bateson, Lynne. “Smells to make You Well.” Daily Express
29) Shane, Simone. “The Calming Effect of Music.” Serendip Health. Daily Express Health RSS, last modified Dec 4 2012, 35) Jacobs, Keither W., and James F. Suess. “Effects of Four
Studio. Serendip Studio, last modified Oct 5, 2008, accessed Sept accessed Sept 18, 2014,http://www.express.co.uk/life-style/ 33) Koga, Kazuko and Yutaka Iwasaki. 3013. “Psychological and Psychological Primary Colors on Anxiety State.” Ammons Scientific
10, 2014, http://serendip.brynmawr.edu/exchange/node/2486. health/362320/Smells-to-make-you-well. Physiological Effect in Humans of Touching Plant Foliage - using 41: Setp 15, 2014207210. doi:10.2466/pms.1975.41.1.207.
30) Ramsay, Adam. “Health Benefits of Music.” Netdoctor., last 32) Sternberg, Esther and Tippett, Krista. “Esther Sternberg - the Semantic Differential Method and Cerebral Activity as Indicators.” 36) Hathom, Kathy and Nanda, Upali. “Guide to EvidenceBased
modified Nov 29, 2011, accessed Sept 20, 2014, http://www. Science of Healing Places.” On Being, last modified 2013, accessed Journal of Physiological Anthropology. Art.” The Center for Health Design., last modified 2008, accessed
netdoctor.co.uk/healthyliving/wellbeing/healthbenefitsofmusic. Sept 17, 2014,http://www.onbeing.org/program/the-science-of- 34) Ulrich, Roger S. 1984. “View through a Window may Influence Sept 19, 2014, https://www.healthdesign.org/chd/research/guide-
htm. healing-places/4856/audio?embed=1. Recovery from Surgery.” Science 224 (4647). evidencebasedart.
36 37
PROJECT STUDIES
Many of the projects and studies in the

previous mindmap experiment with creating Melatonin - Hormone associated with the
onset of sleep (makes body feel tired)
effects on the body without the use of
medications. Studies covered a variety of
Melatonin:
effects from relaxation through the touch of a BLOCKED
plant, promoting alertness by the use of scent,
Perceived time:
calming claustrophobic individuals while in DAY
tight spaces, reducing stress using scent from
fruit, and helping control blood pressure by
the use of music. Melatonin:
RELEASED
SPLIT TIME CAFE Perceived time:
Designed by Philippe Rahm in 2007 in NIGHT
Lebring, Austria, Split Time Cafe illustrates
the power of colour on the body.37 Through
the use of blue light, melatonin is blocked Melatonin:
and people feel more awake. The yellow NATURAL FIG. 3.5. Exterior render of Split Time Cafe
light in another room of the cafe has a long Perceived time:
wavelength which triggers melatonin causing NATURAL
people to feel tired (see Ill. 3.8 & 3.9). A third
room has no colour added to light, thereby
ILL. 3.9. The release of melatonin can
allowing occupants to experience the effects
manipulate the body into thinking it is a (10) BLUE LIGHTS (10) YELLOW LIGHTS (~21) WHITE LIGHTS
of the natural time of day. different time of day, making the body feel Allow brain to naturally
Blocked melatonin release Triggering release of melatonin
more tired or awake. produces perpetuals day produces perpetual night register current day light
Melatonin release blocked

(Wavelengths under 570 nm)
Blue Yellow
Furniture is tall, encouraging Furniture is soft, closer to a lounge White furniture

380 450 495 570 590 620 750 people to stand, therefore typology with sofa-like elements, thereby resembles classic
resembling a bar atmosphere relaxing the body, complimenting the cafe style seating
Wavelength (nm)
onset of melatonin
ILL. 3.8. Colours such as yellow, orange, and red make users feel more tired due to the presence ILL. 3.10. Coloured lights and type of furniture help control the fatigue level in users.
of melatonin, whereas green, blue, and purple make people feel less tired.
37) “Split Time Café.” Philippe Rahm Architectes., accessed Oct

1, 2014, http://www.philipperahm.com/data/projects/splittimescafe/
index.html.
38 39
HARMONORIUM
After investigating the effect of coloured Melatonin:
light on the body, we look at Philippe DECREASED
Rahm’s exploration of the body’s response Effect:
to controlled oxygen levels paired with LOWER FATIGUE
fluorescent lights. Designed by Philippe Rahm SLIGHT EUPHORIA
in 2002 for the 8th Biennale of Architecture
(Swiss Pavilion) in Venice, Harmonorium was
an installation that demonstrated the effect of Nitrogen:
INCREASED
oxygen levels and intense fluorescent white
N
lights on users’ energy levels. The space’s Effect:
nitrogen levels were increased, decreasing SLIGHT
the oxygen levels from 21% to 14.5%. After DISORIENTATION
about ten minutes of being in the space
there was a measurable “natural” increase in
erythropoietin (EPO) and hematocrit levels, as ILL. 3.12. The environmental elements of the
FIG. 3.6. Harmonorium Installation
well as a strengthening of the cardiovascular installation decrease the amount of melatonin
and respiratory systems.38 These protein released in the brain, making people feel less
fatigued. The increase nitrogen creates a
hormones reach the bone marrow, where they
slight disorientation in users.
stimulate the production of red blood cells,
thus increasing the supply of oxygen to the
muscles. This effect may improve the body’s rush of new energy stimulated by the space
physical capabilities by up to 10%. With this and created by the body using its own brain
boost in oxygen to the muscles, users feel a pharmaceuticals (see Fig. 3.11 & 3.12).
(4) WHITE BENCHES (528) INTENSE FLUORESCENT WHITE LIGHTS

This very bright light of 5,000 and 10,000 lux
stimulates the retina transmitting signals to the
3000m
pinean gland in the brain resulting in decreased

N O melatonin secretion.
ILL. 3.11. Increasing the level of nitrogen reduces the oxygen level from 21% to 14.5%, which is ILL. 3.13. The intense lights and lack of oxygen make people feel euphoric and less tired.
found at altitudes of about 3000m.
38) “Hormonorium.” Philippe Rahm Architectes., accessed Sept 27,

2014, http://www.philipperahm.com/data/projects/hormonorium/
index.html.
40 41
DIURNISM
The effects of yellow and blue coloured Melatonin:
light were examined in Split Time Cafe (see RELEASED
Ill. 3.14 & 3.15). Similarly, the Diurnism Perceived Time:
installation explored the effect of a coloured NIGHT
light, paired with soft music. Designed by
Philippe Rahm, Diurnism was an installation
for the Airs de Paris exhibition that consisted
of a room with yellow and orange lights ILL. 3.15. The orange triggers the body to
release melatonin making people feel fatigued.
(creating a orange glow), a sound absorbing
board, two soft cushioned benches, and
speakers playing reversed nocturnes for the
piano.39 The soft material on both the sound
absorbing board and the benches helped to
create a quiet, calming atmosphere. Orange
light has a long wavelength, triggering the
release of melatonin, making people feel FIG. 3.7. Diurnism Installation
tired. During the exhibit, visitors were found
sleeping on the benches, demonstrating the
powerful effects of their environment.
ORANGE AND YELLOW

ALTERNATING LIGHTS
This light combination produces (~120) LIGHTS (1) SOUND ABSORBER
orange glow in gallery. The
Melatonin released wavelengths of the coloured lights
(Wavelengths over 570 nm) are over 570 nanometers, and are
perceived by the body through the
Diurnism melatonin rhythm as a true night.
Reversed “nocturnes for the

380 450 495 570 590 620 750 piano” by the early 19 century Irish
Wavelength (nm) musician John Field are played
through speakers (5) SPEAKERS (2) BENCHES
ILL. 3.14. Orange has a wavelength of over 570nm; therefore, the colour triggers the brain to ILL. 3.16. The orange light and music from speakers makes people feel very fatigued.
release melatonin, causing the body to feel tired.
39) “Diurnism.” Philippe Rahm Architectes., accessed Oct 1, 2014,

http://www.philipperahm.com/data/projects/diurnisme/index.html.
42 43
FIG. 3.8. The Rain Room installation enables FIG. 3.9. Nocti Vagus Restaurant in Berlin is a FIG. 3.10. Light Therapy at bus stops has been FIG. 3.11. NASA Light Bulb helps promote
people to walk amidst the water without restaurant completely in the dark. shown to decrease stress in Sweden. sleep.
getting wet.
Split Time Cafe, Harmonorium, and Dirunism NOCTI VAGUS BUS STOPS IN SWEDEN NASA LIGHT BULB
show how colour can affect the senses. The Nocti Vagus is a restaurant in Berlin that Seasonal Affective Disorder (S.A.D.) is a type The NASA Light Bulb helps promote sleep
following four projects are reviewed for their creates a unique experience of dining in the of depression that is related to the change of by the light it emits. Typical light blubs emit
ability to affect the senses in other ways. dark. Restaurant owner Simone Glosh was seasons. Typically, the winter months bring more blue light with a short wavelength
inspired by a similar experience she came on more depression with the short amount of which suppresses the release of melatonin,
RAIN ROOM across in Hamburg where blind people daylight hours. In Sweden, this issue is even the sleep promoting hormone (see Fig. 3.11).
Rain Room is an installation created in 2012 would guide a sighted group around a dark more magnified in comparison to Toronto, The NASA Light Bulb reduces the amount of
that responds directly to the user’s physical city, and no one could see where they were Canada, due to its more northern latitude. In blue light emitted by approximately 50% to
position in the space, allowing them to walk going. There, sighted-people would begin to order to help fight this winter depression, bus help promote sleep. The creators recommend
amidst water falling from the ceiling without understand a world without sight. Inspired stops in Umeå, Sweden have been installed having the light bulb on for approximately
ever getting wet. In a 100 square-metre area, by this experience, Glosh decided to create with bright UV lights to help make up for 30 minutes before bed to help you fall asleep
water valves above create a light rainfall from her own experience, where she could eat in the lack of daylighting received during this faster in order to get a better night’s sleep.43
the ceiling of the room over a grated floor the dark and also enjoy a theatre performance time of year. The utility company replaced
(see Fig. 3.8). As the user begins to enter into while in the dark, and thus was born, Nocti the normal bus stop lamps with specially This light bulb has been so successful that it
this zone, the installation detects where the Vagus. When visitors arrive, they first order designed phototherapy tubes (see Fig. 3.10). is used by astronauts in space to help them
person is and blocks the water from falling their dinner before proceeding down the The city of Umeå, approximately 300 miles sleep and maintain their natural circadian
onto them. As the user moves through the stairs where a staff member guides them north of Stockholm, receives about four rhythm.
gentle rain from the ceiling, sensors continue through the dark to their table. The darkness hours of sunlight a day during the month
to monitor this movement allowing the user forces people to relax, and move slowly of December. “Winter is in many ways a
to walk about, seeing, smelling, and hearing (see Fig. 3.9). To compensate for the lack of fantastic season, with the darkness and the
the water all around without ever getting light, feeling the table and listening to people cozy atmosphere. But when the sun appears
wet.40 becomes much more important.41 as a minimum, [we] need the energy the
most,” Umeå Energi explains.42
42) Boyle, Rebecca. “To Fight Winter Blahs, Sweden Offers Light
Therapy at the Bus Stop.” Popular Science., last modified Nov 29
2012, accessed Oct 25, 2014, http://www.popsci.com/technology/ 43) “The NASA Sleep Promoting Light Bulb.” Hammacher
40) “Rain Room.” RANDOM., accessed 30 December, 2014, http:// 41) Report about Dark Restaurant NOCTI VAGUS (Berlin). article/2012-11/fight-winter-doldrums-swedish-electrical- Schlemmer., accessed Jan 19, 2015, http://www.hammacher.com/
randominternational.com/work/rainroom/. YouTube. Directed by YouTube User anike1990. 2012. company-showers-bus-stations-uv-light. Product/Default.aspx?sku=86494.
44 45
PRECEDENT PROJECTS
FIG. 3.12. Commonweal Retreat Center, FIG. 3.13. Commonweal Retreat Center, FIG. 3.14. Maggie’s Centre, Nottingham, FIG. 3.15. Maggie’s Centre, Dundee, Scotland
Pacific House Kohler House Communal Space in Kitchen (Space to spend quiet time alone)
The following projects illustrate how TREATING THE WHOLE PERSON MAGGIE KESWICK JENCKS MAGGIE’S CENTRE
environments have been designed to help The “tradition of western medical science, Maggie Keswick Jencks was diagnosed with Maggie’s husband, Charles Jencks, was an
people cope emotionally with the disease tend[s] to regard illness as a kind of breast cancer and died in 1995. She wrote architect who listened to Maggie’s wishes,
they have and the suffering they endure. mechanical breakdown that afflicts our bodies extensively about her experience in various turning her ideas into what is now a series
and requires a mechanic under the hood, articles, focusing on the lack of social and of 15 locations of Maggie’s Centres around
COMMONWEAL replacing the parts, rewiring the connections, psychological support she had at the hospital. the world, with many new centres planned.
Sand is used for therapeutic reasons, as it cleaning the carburetor”.45 In describing a As many others do, she explains the diagnosis Maggie’s Centre is a retreat for cancer patients
is pleasant to the touch. It is used to sculpt patient, the person is often referred to as of cancer as a kick in the stomach. “Maggie got to seek comfort with their illness and come
representations of one’s hopes or fears in “the site” of where a disease is situated. The her diagnosis [of cancer]... in her 20-minute to terms with what they are facing while
the unconscious. The staff at Commonweal description of a person with an illness goes slot with the consultant, who then said ‘I’m experiencing support from others. Karen
fully recognize you cannot separate a further to represent the person as a whole who really sorry, I know it’s terrible news, but Verrill, Head of the Newcastle Maggie’s,
disease, condition or tumor from the person. is going through an experience involving a I’ve got another patient to see.’”47 Although says: “When you’re having routine treatment
The person and the tumor itself are all part disease. “Healing is a matter of meaning, not healthcare does require time, money, and a for a life-threatening illness like cancer,
of one body. “People often associate their mechanics… here [at Commonweal Retreat schedule in order to operate properly, there that’s when the environment make more of
identification with the disease and with Centre for people with cancer] it is not the are very sensitive moments when patients are a difference.”49 All Maggie’s Centres have a
being a ‘cancer patient’”.44 This label itself patient who is healed, but the person.”46 so completely overwhelmed, hardly able to kitchen and a garden to stimulate socialization
only makes the person feel worse. The right Holistic healing encompasses healing of both process what is being told to them, that they for those who desire it, but also offer many
perspective and a shift of thinking can turn the body and the mind (including the spirit) should never have to worry about logistics of private areas for those wanting to spend time
this around. If people believe cancer doesn’t simultaneously (see Fig. 3.12 & 3.13). This the hospital’s system. What Maggie needed on their own (see Fig. 3.14 & 3.15). Areas
have them, they hold much power over the approach views the patient as a whole person, was a more comforting, more pleasant, reveal themselves as one explores the spaces
disease, and they gain the ability to not allow not limiting healing methods to only the “more human place to absorb what was to keep people alert and interested. It lends
the illness to control all of their conscious physical conditions. happening.”48 She then worked alongside her itself to what people need. It is “somewhere
thinking. husband to create Maggie’s Centre. safe we can retreat to or hide if necessary.”50

Recover Faster?” Gizmodo., last modified Nov 25 2014, accessed
45) Moyers, Bill. 1993. "Wounded Healers." Parabola, the Dec 9, 2014,http://gizmodo.com/can-the-design-of-hospitals-help-
44) Kabat-Zinn, Jon. 1990. “On Healing.” Chap. 13, In Full Magazine of Myth and Tradition, 22. patients-recover-faste-1663083331. 49) Ibid.
Catastrophe Living, 174. New York, NY: Dell Publishing. 46) Ibid. 48) Ibid. 50) Ibid.
46 47
CENTRE FOR CANCER AND HEALTH walls (see Fig. 3.16 & 3.18). The goal for
Similar in use to Maggie’s Centres, the this design was to create a space that people
Centre for Cancer and Health is a recovery could come to for support without feeling as
and retreat centre for patients dealing with if they were in a medical facility. The lack of
cancer. Designed by Nord Architects in institutional materials and confusing signage
2011 in Copenhagen, Denmark, light was in this building typology helps visitors forget
very important in the design of the building. about cancer when the enter the building (see
Northern Europe doesn’t receive a lot of light Fig. 3.17). “A human scale and a welcoming
during the day in the winter months. To allow atmosphere can help people to get better... If
as much light as possible into the space, we want people to get better at our hospitals,
almost all of the roofs host skylights and a we need to deinstitutionalize and create a
variety of different shaped windows line the welcoming healthcare.”51
Interior material palette
FIG. 3.18. Interior view of the Centre for Cancer and Health
White walls Wood floor Windows
Exterior material palette
MORPHOLOGY
SECTION
White tile Wood siding Wood siding LOOKING WEST
FIG. 3.16. View of the interior courtyard at the FIG. 3.17. Materials of the Centre for Cancer ILL. 3.17. Spatial Qualities of the Centre for Cancer and Health
Centre for Cancer and Health and Health are very neutral and soothing.
51) “Center for Cancer and Health Danish Architecture Centre.”

Danish Architecture Centre., accessed Oct 2, 2014, http://www.dac.
dk/en/daclife/copenhagenxgallery/cases/centerofcancerandhealth/.
48 49
SHINRIN YOKU - FOREST BATHING PHYTONCIDES IN THE FOREST
Southdown Institute and Thorncrown Chapel Phytoncides are chemicals or vapours
both emphasize the connection with nature. released from wood and other plants. These
Shinrin Yoku is the art of letting Mother vapours, which are natural to the forest
Nature in through all of your senses. setting, decrease brain activity when inhaled
and therefore lower stress response. The
We humans have spent more than 99.99% inhalation study of fragrances given off
of our evolutionary history in “natural” by wood chips of sugi and hiba or asunaro
FIG. 3.19. Southdown Institute environments, and, therefore, it is believed showed lower systolic blood pressure, and
SOUTHDOWN INSTITUTE THORNCROWN CHAPEL that we are essentially nature adaptive. brain activity was subdued. Interestingly,
Being able to put suffering aside and Throwncrown Chapel, desgined by E. Fay However, more and more people are living when the test subjects of a study in Japan
focus on a positive mindset is crucial for Jones, is located amongst the woods just in an urban and artificial society, while our found the fragrances unpleasant, their body
healing. Southdown Institute is a retreat outside of Eureka Springs, Arkansas (see Fig. physiological functions are still adapted to still showed no signs of stress.55
centre in East Gwillimbury, just north of 3.20). The chapel consists of 6000 square feet nature.54 Dr. Marc Berman performed a study
Newmarket, Ontario, for men and women of glass to allow the exterior of the building that found urban environments inflicted much 10 minute walk in forest vs. urban setting
with addictions and mental health issues to be part of the interior experience. more stress on the body due to the level of • Sympathetic nervous activity (represents
(see Fig. 3.19). This new haven opened attention that these environments demanded state of stress) is low when looking at
in December 2013, surrounded by nature. “Light, shadows, and reflections play a major (see Ill. 3.18). nature, and stress is suppressed in forest.
The centre takes advantage of the beautiful role in Thorncrown’s ambience. Because • HR is about 12 beats/minute lower in
location, offering “soothing nature, comfort, of the chapel’s elaborate trusses and the Our bodies are rarely in the “expected” state of forest.
and privacy” says Chief Executive Officer surrounding trees, constantly changing our natural well-being. The ultimate comfort • Brain activity lowered in forest.
Dorothy Heiderscheit. It was designed with patterns of light and shadows appear during comes from the harmonization of rhythm
the specific users in mind, who, while dealing the day.”53 between human beings and the environment.
with addictions and mental health issues,
need as much encouragement and comfort
as possible to be able to relax and “do the Attention Restoration Theory
inner work that they [need] to do,” says
Heiderscheit. During an especially difficult
journey to heal, community and support
from others in similar situations are key. The
centre has 22 beds and is located in a very
Directed Attention Involuntary Attention
secluded area. “What I notice dramatically
Requires person to be more vigilent Allows mind to relax
is the community is closer together here,” (more stressful)
which Heiderscheit attributes to the smaller
space.52 FIG. 3.20. Thorncrown Chapel, Arkansas ILL. 3.18. Attention Restoration Theory by Dr. Marc Berman
54) “The Nature of Things with David Suzuki, Dreams of the

52) Remy, Ruane. 2014. “Southdown has Right-Sized.” Catholic 53) “Architecture.” Thorncrown Chapel., last modified 2015, Future, Science of Natural Therapy.” CBC. CBC, last modified
Register, Sept 14, 2014, 13. accessed Jun 4, 2015, www.thorncrown.com/architecture.html. 2014, accessed Oct 10, 2014. 55) Ibid.
50 51
The body uses a variety of brain compares traditional hospitals built in the
pharmaceuticals to respond to environmental 1800’s with contemporary hospitals built
conditions. Certain environmental qualities Post-WWII and examines the shift away from
such as colour, light, and scent have the ability natural healing and how this affects patients.
to stimulate brain pharmaceuticals and can Holistic healing is further discussed in this
be used to trigger different body reactions. section, looking at the effects of the placebo
This can include stress reduction, which effect relating to natural landscapes.
is beneficial to avoid the use of traditional
drugs, which can be very harmful and
potentially highly addictive. Spilt Time Café
(by Philip Rahm) and the Japanese concept of
Forest Bathing (Shinrin Yoku) demonstrated
strategies to trigger brain pharmaceuticals
without the use of dangerous medications.
Several medical treatment spaces such as
Commonweal Retreat Center and Maggie’s
Centres have taken the approach of holistic
design, which can be used as precedents for
hospital design.
The research presents the major influences

that environmental elements can have on
one’s body and one’s psychological state,
including colour, light, views, scents, etc.
Further in this regard, the power of the mind
has much potential in healing, as well as
with the coping of suffering. This part has
explored the importance of holistic healing,
treating the patient as a whole person, and not
as the site of a disease.
As understood in Part III, while taking

a holistic approach of healing, we must
consider environments because they play
such a crucial part in one’s healing. Part IV
53
H
PART IV: HEALING ENVIRONMENTS
Examining the conditions of current healing spaces
55
HISTORY OF HEALING SPACES
A summary of Heather Burpee’s “History of Healthcare Architecture”1
FIG. 4.1. Thomas Guy’s Hospital was designed FIG. 4.2. Hôpital Lariboisiere, Paris, opened in
around a central courtyard in London, opened 1854.
in 1726.
Western hospitals have been transformed The recognition of healthy agents such as
drastically in their form and use throughout clean air and hygienic conditions prompted
history. Healing used to take place in the new health standards to be implemented for
home, next in the church then in central the basic formation of hospitals. This was
hospitals. The role of architecture has prompted by Louis XV in Paris. The pavilion
changed immensely, recently emphasizing building typology became very influential.
the value of function and technology, causing The first hospital of this new typology was
environmental qualities to be neglected.1 Hôpital Lariboisiere in Paris, built between
1839 and 1854, designed by M.P. Gauthier
CENTRAL,NATURE-ENCOMPASSING (see Fig. 4.2).
HOSPITALS
When central hospitals were first built, Florence Nightingale (1820-1910) was very
they were run by religious orders, but they influential following the Crimean war (1854)
maintained a very distinct civic role within and has been lauded as the mother of modern
the city. Hospitals were often structured nursing. She recognized that there was a
around large central courtyards, such as correlation between a hospital’s cleanliness
Thomas Guy’s Hospital, which opened and patient survival rates. After observing
in 1726 (see Fig. 4.1). This building this she was able to reduce the death rate of
style of the urban hospital landscape wounded soldiers from 60% to 2% within six
carried throughout the 19th Century.2 short months.3 In addition to her discoveries
about hospital hygiene practices, she wrote
1) Burpee, Heather. 2008. “History of Healthcare Architecture.” 1. 3) Ibid.

2) Ibid. . 4) Ibid..
57
building technology encouraged the use behaviour, and need less pain medication
of mechanically ventilated interior spaces than those patients who had a view of a brick
and elevators to move people vertically. wall outside their window. Ulrich says: “the
Circulation became very confusing with little capability for healthcare to help improve
external cues as to where you were. Nurses outcomes in patients is directly related to
spent 40% of their time traveling from one their ability to reduce stress and promote
place to another.7 The hospital turned into buffering and coping.”11
more of a well-tuned machine and became
the precedent for future “mega-hospitals”8
(see Ill. 4.1), completely limiting access to
FIG. 4.3. St. Thomas Hospital in London built FIG. 4.4. Hicks U.S. General Hospital, the air, light and views that Nightingale had
between 1861 and 1865. Balitmore so carefully attributed to her patients’ well-
being.9
about her approach for creating a healing continued to influence hospital design for the
environment, which not only encompassed next hundred years (see Fig. 4.3). RE-EXAMINATION OF HOSPITALS
the physical surroundings, but also the In the 1980’s, Northern Europe began
important of natural light, fresh air, landscape, Hicks U.S. General Hospital in Baltimore was a movement to re-examine the hospital
and attention to diet.4 built during the civil war and was designed to typology and its downfalls as it existed.
fill the need for isolation to prevent infectious Many new hospital designs changed the
In her book, Notes on Hospitals (1863), diseases from spreading. Heavily influenced typical form to allow more access to daylight
she wrote: “[light is] quite perceptible in by Nightingale’s writings, the hospital wings and exterior spaces to occupants.
promoting recovery, the being able to see allowed for ample natural light to penetrate
out of a window, instead of looking against through all patient rooms, enabled cross Emerging in the 1980’s, Evidence Based
a dead wall; the bright colors of flowers; the ventilation through the spaces, and created Design research is a relatively new field of
being able to read in bed by the light of a views of the gardens between the building research that studies the correlation between
window close to the bed-head. It is generally crenellations (see Fig. 4.4). indoor building environments and human
said that the effect is upon the mind. Perhaps health and productivity. Dr. Roger S. Ulrich,
so; but it is no less so upon the body on that SHIFT TO EFFICIENT, MACHINE- conducted a study in 1984 to determine if
account5.” LIKE HOSPITALS certain views out of the window in a hospital
Following World War II, Nightingale’s room would have any affect on a patient’s
Nightingale’s principles were first original concept of hospitals with fresh recovery from gall bladder surgery.10 The
implemented in St. Thomas’ Hospital in air, plenty of light, and views was replaced study, entitled “View through a window may
London, England, built between 1861 and with a “podium on a platform” typology influence recovery from surgery,” found that
1865, designed by H. Currey. Nightingale’s that consisted of tall buildings with deep patients who had a view of a green park were ILL. 4.1. Evolution of healthcare from home to
insight on hospitals and patient health plans to prioritize efficiency.6 Advanced more likely to recover faster, have better the ‘Podium on a Platform’
8) Ibid. Page 2.
6) Ibid. Page 2. 9) Ibid. Page 2.
7) Ibid. Page 2. 10) Ulrich, Roger S. 1984. “View through a Window may Influence
5) Burpee, Heather. 2008. “History of Healthcare Architecture.” 1. 8) Ibid. Page 2. Recovery from Surgery.” Science 224 (4647). 11) Ibid.
58 59
ARCHITECTURAL PLACEBO EFFECT
FIG. 4.5. Maggie’s Centre, Edinburgh FIG. 4.6. Maggie’s Centre, Nottingham FIG. 4.7. Maggie’s Centre, Glasgow
Stress is ultimately the largest hurdle to deal immune system was actually affected by a ARCHITECTURAL PLACEBO dealing with cancer. Many describe these
with to overcome illnesses. The placebo effect psychological learning and reacted even when Environments can act similar to placebos. spaces as an oasis; a place to meet people or
is known as a fake treatment that does not the drug had not been present.13 In a way, the Placing patients in environments where the sit quietly alone with a cup of tea. The centres
hold any active substances itself but helps the sugar water in the experiment with the rats stress response isn‘t activated encourages are flexible and allow people a variety of
body heal simply by the mind’s expectation acted as a placebo by tricking the mind into the brain to release natural, stress fighting different things to do to relax and help them
that it will heal and allows the brain to activate thinking it was receiving some kind of drug chemicals. cope with their conditions. By providing a
anti-pain pathways releasing endorphins that would suppress the immune system, but space for people to come to when they need
(dopamine). Placebos can ultimately reduce the body began doing that on its own. This Charles Jencks was inspired, after watching support, it allows them to relax and focus
swelling and pain and, in turn, reduce stress can also work in the opposite way, tricking his wife’s struggle with breast cancer to on being in the present moment. From the
which makes the body better able to receive the mind into using its own chemicals to get design retreat centres for those dealing with carefully designed interiors to the supportive
medical treatments, providing the best positive results that are able to reduce stress. cancer (see Fig. 4.5, 4.6 & 4.7). He believes social network, the compassionate staff
opportunity for the brain to heal the body.12 In in the architectural placebo effect. He fully members and the incredible natural views
“
the study conducted by Dr. Robert Ader and supports taking great care of the care givers. out of all the windows, the entire project
„
Dr. Nicholas Cohen at Rochester University Improving the mood of the care givers is geared towards reducing stress to aid
Medical School [previously mentioned in Environmental variables are really translates over to the patients with positive people in strengthening their state of mind.
Part III in Power of the Mind] tests involved important. They‘re affecting the results. He used this philosophy to guide his William James, the American philosopher
giving rats immunosuppressing drugs while brain‘s stress response and the design of the Maggie’s Centres, a series of and psychologist, believed that “the greatest
exposing them to a sweetening chemical in brain’s relaxation response.14 retreats for people dealing with cancer with revolution in our generation is the discovery
their drinking water. Their brains became over 15 locations in the United Kingdom that human beings, by changing the inner
so accustomed to this combination that their Esther Sternberg and around the world. There, people receive attitudes of their minds, can change the outer
practical, emotional, and social support for aspects of their lives.”15
13) Kabat-Zinn, Jon. 1990. “On Healing.” Chap. 13, In Full

12) Sternberg, Esther and Tippett, Krista. “Esther Sternberg - the 14) Sternberg, Esther and Tippett, Krista. “Esther Sternberg - the
Science of Healing Places.” On Being, last modified 2013, accessed Science of Healing Places.” On Being, last modified 2013, accessed
Sept 17, 2014,http://www.onbeing.org/program/the-science-of- Sept 17, 2014, http://www.onbeing.org/program/the-science-of- 15) Levitt, Andrew. 2015. The Inner Studio. A Designers Guide to
healing-places/4856/audio?embed=1. healing-places/4856/audio?embed=1. the Resources of the Psyche. Arch 641 Lecture.
60 61
PLANTSAND NATURALLANDSCAPES approach things.”17 It is not just a picture or
Plants and natural landscapes have a very a view that is important, but an attitude of
powerful impact on those who are ill. Roger the mind. A plant is not just a plant, but a
Ulrich’s study, A View Through a Window, representation of how we can feel and how
tested post-surgery patients recovering from we can change how we see ourselves. Plants
gall bladder surgery, dividing them into two and calming environments have the ability
groups; one group viewed a park outside of to allow delicate forms and delicate people
their hospital window, and the other group to thrive. It is okay to be fragile, especially
saw a brick wall. It was found that patients during times of struggle.
with a view of the park needed less pain
medication, had less negative nurse notes, REHAB CENTRE, SWITZERLAND
and, on average, were discharged a day Rehab Basel, a rehabilitation centre by
sooner.16 It has been shown in other studies Herzog and De Meuron, incorporates nature
that paintings or photographs of nature have into its design. Here, patients come to recover
the same positive effect on patients. Plants from head and spinal cord injuries. The centre
and elements of nature represent healing, focuses on improving the quality of life
growth, and hope. “If only we, like de Hooch, for those with life-changing injuries, often
knew how to recognize the value of ordinary leaving them paralyzed.18 Each room receives
routine, many of our burdens would be lifted. light from both a skylight above and from an
His painting [of an ordinary linen closet] outside balcony. The natural materials of the
suggests that the big theme of life – the search architecture as well as the natural landscape
for prosperity, happiness, good relationships surrounding the centre help with relaxation
– are always grounded in the way we and reduction of stress during their recovery
(see Fig. 4.8, 4.9, 4.10, 4.11 & 4.12).
FIG. 4.10. Rehab Centre, Courtyard
FIG. 4.8. Rehab Centre, Aerial View FIG. 4.9. Rehab Centre, Courtyard FIG. 4.11. Rehab Centre, Walkway FIG. 4.12. Rehab Centre, Pool
16) Ulrich, Roger S. 1984. “View through a Window may Influence

Recovery from Surgery.” Science 224 (4647). 18) “Rehab Basel.” MIMOA; Mi Modern Architecture., last
17) De Botton, Alain. 2013. “Art for Life’s Sake.” Wall Street modified 2015, accessed Jan 2, 2015, www.mimoa.eu/projects/
Journal, 84. Switzerland/Basel/REHAB%20Basel.
62 63
working with a human being who is looking around the doctors, not expectant mothers.
for some personal care. Picard says that “with The number of cesarean sections (C-Sections)
our desire to cure, we over-treat.”23 in the last 10 years have skyrocketed and are
often scheduled between 9a.m. and 5p.m.,
On a more personal note, I [Jennifer Monday to Friday. Therefore, baby birthdays
Beggs] watched my Mom battle through are being determined and planned around
cancer treatment. New drugs or new tests the doctors’ social calendars, instead of
didn’t mean much to her. She didn’t know nature. Robbie Davis-Floyd24 explains that
what these fancy medical terms meant C-Sections are easy to predict and control.
and certainly didn’t understand all of the Once it is scheduled, you know when the
medications the doctors would speak about. doctors are needed, and it makes it easier to
Like most average patients, she didn’t fully control staffing requirements. Yet C-Sections
understand what all the doctors were doing, can be quite dangerous, can introduce more
but she had to place her trust in them. What complications to giving birth, and have long
FIG. 4.13. Two of Joana Johnston’s images, part of her exhibit exploring institutional architecture. made her happy was when the doctor held her recovery periods of approximately six weeks.
hand when giving her the news of tests, or
IMPORTANCE OF HUMAN SPACES As part of her project, Johnston interviewed gave her a hug when the news wasn’t good. As discussed in Part II, North American
As hospital procedures and medical testing seven patients to find out how they feel as That’s what made the difference when she hospitals are also known for their heavy
becomes more advanced and machine- they enter the hospital, and where they felt was in her most vulnerable moments at the use on pain medications for child birth,
controlled, so does the care that hospitals the most comfortable. “Unsurprisingly, none hospital. “You know what people really long specifically using the epidural to artificially
provide. In a space where many are facing of the volunteers for Johnston’s photography for? Personal Medicine, not personalized induce labour. The typical debate is when a
life-threatening illnesses, the more they are project named the hospital as their safe and medicine. They crave human connection. Not woman should get her epidural, rather than
treated like an object, the less they may feel comforting place. Almost all chose their just care, but caring,” Picard says. if she will get one. From 1990-2000, the
cared for. homes and private bedrooms, often describing number of inductions increased from 10%
the view out their windows.”21 SCHEDULING AROUND DOCTORS to 20%, doubling in just 10 years. This trend
Photographer Joanna Johnston (daughter “We have built ourselves a sickness system demonstrates that more and more doctors
of a healthcare architect) says: “There’s no In his convocation speech, Andre Picard rather than a health system. We have are encouraging women to get an epidural,
design in the hospital. There’s design for speaks to the graduating medical students designed that system for the convenience of because it speeds up the labour process.
clinical function. There’s design for safety. and shares some of his insights on healthcare. practitioners, not patients,” says Picard. In the This isn’t necessarily better for the mother
But there isn’t design for humans to actually He says: “Sadly, most doctors don’t put online documentary “Pregnant in America” or baby, but it saves time waiting around for
be humans.”19 In June 2015, Johnston set up a patients first.”22 His point here is that, with discussed in Part II, as expecting couple Steve the natural birthing process to take its natural
photography exhibition to not only document advancing medical technology and the focus and Mandy Buonaugurio explore the benefits course.
the interior of hospitals, but to critique “how on so many new drugs and ways of testing and risks of giving birth at home rather than in
hospital design works against the healing for different conditions, doctors often focus a hospital, they discover that today many child
mission of the institution”20 (see Fig. 4.13). on the symptoms and forget that they are birth procedures and schedules are organized
22) Picard, Andre. “A Challenge for New Doctors: Focus on the

Patient, Not just the Symptoms.” The Globe and Mail. The Globe
19) Swan, Michael. 2015. “Bringing the Human Back into Hospital and Mail, last modified Jun 9 2015, accessed Jun 10, 2015, http://
Design.” Catholic Register, 14 June, 16. www.theglobeandmail.com/life/health-and-fitness/health/a-
20) Ibid. challenge-for-new-doctors-focus-on-the-patient-not-just-the- 24) Robbie Davis-Floyd, PhD, is a Medical Anthropologist at the
21) Ibid. symptoms/article24859080/. 23) Ibid. University of Texas
64 65
EXISTING HOSPITALS - POSITIVE EXAMPLES
CAN THE DESIGN OF HOSPITALS

HELP PATIENTS RECOVER FASTER?
There are many positive examples of hospitals
where the environments help support the
Special Care
patients, mentally, and emotionally. Consider
the Dyson Centre for Neonatal Care in the
Royal Hospital in Bath, England, designed by
Feilden Clegg Bradley Studios, Architects.
Its light, airy, and spacious environments
don’t resemble the typical hospital. With Home
natural woods and soothing green colours, it
feels more like a Scandinavian Spa.
FIG. 4.14. Dyson Centre for Neonatal Care in
the Royal Hospital in Bath, England designed
NEONATAL ICU AT DYSON CENTRE by Feilden Clegg Bradley Studios, Architects
The Neonatal Intensive Care Unit (ICU) is which opened in July 2011.
designed in the shape of a horseshoe, darker Intensive
at one end for the high-dependency babies and white walls. Surfaces reflect sound, and
Care
and then progressively brighter with fewer privacy is almost non-existent. James Dyson,
machines and bigger, healthier babies (see Ill who finished and funded part of the Dyson
4.2). This progressive design is for the babies’ Centre, believes that “good design can make
comfort at different stages of development people get better more quickly”.26
and allows the parents to recognize the
progress and development their babies are The design of the Neonatal ICU has
making, as they move around the horseshoe shown to have had positive effects, not Birth
when they grow and become healthier. This only psychologically, but also in babies’
gives parents a great sense of hope. development and growth. Babies in the centre
sleep for 20% longer than those in the old
unit,3 which is crucial for the development ILL. 4.2. Conceptual plan of the Dyson Centre for Neonatal Care in the Royal Hospital in Bath,
The design sketches of the hospital show England designed by Feilden Clegg Bradley Studios, Architects which opened in July 2011.
“the building like a hug, its arms enveloping of babies who are so young.27 Dr. Bernie
a baby. ‘The whole point...was to provide a Marden, a consultant neonatologist, explains
secure base.’”25 In this way, the building is that sleep for premature babies is “when all
an average of 30 minutes longer visiting in a 64% of those in the old unit.30 Breastfeeding
acting like a nurse, a caregiver (see Fig. 4.14). the brain development gets done.’28
day. Visitors and staff both reported “feeling has been observed to lower the risk of many
less cramped and less stressed that those negative health outcomes for both the mother
Typically, hospitals tend to make patients The architecture of the space also had an effect
in the old unit.”29 It was also observed that and infant.
and staff more stressed with the bright lights on adults. It was observed that parents spent
90% of babies were breastfed, compared to

Recover Faster?” Gizmodo., last modified Nov 25 2014, accessed 26) Ibid.
Dec 9, 2014, http://gizmodo.com/can-the-design-of-hospitals-help- 27) Ibid.
patients-recover-faste-1663083331. 28) Ibid. 29) Ibid. 30) Ibid.
66 67
FIG. 4.16. Exterior view of the “View Dynamic FIG. 4.17. “View Dynamic Glass” can stop
Glass,” which carefully controls light light from penetrating through by the touch of
penetration. a button, without the use of curtains.
Patient rooms have also been carefully & 4.17). Handing over control to the patient
designed. There has been an emphasis placed helps ensure they are comfortable and gives
on giving control to patients to allow them back some authority that they desperately
to take charge of their environments. A TV have been seeking ever since coming into
screen allows patients to watch television the hospital.34 Also, patient control of many
programs, as well as FaceTime or to “Skype” aspects of the room will decrease the amount
loved ones and call one of the nurses, who of time nurses are called to do simple things
will all have hand-held devices for this that don’t require a nurse’s expertise, such
FIG. 4.15. Still under construction, this is what an inpatient room may look like at HRH.
purpose (see Fig. 4.15). Patients can also as closing curtains or changing the room
use their TV to view any medication charts temperature. This frees time for the nurses to
HUMBER RIVER HOSPITAL with patients in mind.31 Like the Dyson or test results that the doctor would like to attend more critical situations. A comfortable
Humber River Hospital (HRH), located in Centre, Humber River was designed for ease share with them.33 Patients will also have room also encourages loved ones to visit,
Toronto, is currently under construction of use as well as to eliminate the spread of control of the room temperature from their which also helps the patient feel supported.
(as of 2015) and will be the first “fully infections on surfaces such as door handles. bed and the ability to change the opacity of HRH will offer visiting hours 24 hours a day
digital” hospital in North America. This Doors at HRH will open with a simple wave windows. Using “View Dynamic Glass” tiny to encourage people to visit whenever it is
new digitalization will assist with diagnostic of the hand in front of a button, and lights rods can change how much light penetrates convenient for them.
testing, blood samples, and communication will be motion-sensitive to avoid having to through the glass, and windows can change
between doctors and lab results, in addition to touch light switches.32 from being completely transparent to opaque
the user friendly features that were designed without the need of curtains (see Fig. 4.16
31) Christie, Nathan. “Touring the Huge New Humber River

Hospital, Part Two.” Urban Toronto., last modified Apr 1 2015,
accessed May 5, 2015, urbantoronto.ca/news/2015/04/touring-
huge-new-humber-river-hospital-part-two.
32) Ibid. 33) Ibid. 34) Ibid.
68 69
HOSPITALS IN ONTARIO THAT OFFER CHEMOTHERAPY
There are approximately 115 hospitals in

Ontario that offer chemotherapy (see Ill. 4.3),
14 of which are Regional Cancer Centres Grand River Regional Cancer Centre Trillium Health Centre Winchester District Memorial Hospital
which typically offer a wider variety of Cambridge Memorial Hospital William Osler Health Centre Simcoe Muskoka RCC/Royal Victoria Hspl
treatments and help set standards for cancer Guelph General Hospital Odette Cancer Centre Collingwood General and Marine Hospital
Grand River Hospital Princess Margaret Cancer Centre Huronia District Hospital
care.35 While new cancer-care facilities Groves Memorial Community Hospital Mount Sinai Hospital Muskoka Algonquin Healthcare (Bracebridge &
will continue to be built, there is a vast Louise Marshall Hospital St. Joseph’s Health Centre Huntsville)
need for design interventions that can be North Wellington Health Care Corp. St. Michael’s Hospital Orillia Soldiers Memorial Hospital
St. Mary’s General Hospital Toronto East General Hospital Hôpital Régional de Sudbury Reg’l Hspl
implemented in existing hospital spaces. The
Windsor Regional Cancer Program Women’s College Hospital Blind River District Health Centre
aim of this thesis is to study existing healing Bluewater Health Stronach Regional Cancer Centre Chapleau General Hospital
environments and the possible interventions Chatham Kent Health Alliance Humber River Regional Hospital Kirkland Lake and District Hospital
that can be undertaken to retrofit existing Hotel-Dieu Grace Hospital Markham Stouffville Hospital Corporation Manitoulin Health Centre/Mindemoya
Leamington District Memorial Hospital North York General Hospital Muskoka Algonquin Health Care
spaces. Windsor Regional Hospital Southlake Regional Health Centre Lady Minto Hospital – Cochrane
London Regional Cancer Program Stevenson Memorial Hospital North Bay General Hospital
The following pages compare five different Alexandra Hospital York Central Hospital Sault Area Hospital
chemotherapy suites from around the world: Alexandra Marine and General Hospital R.S. McLaughlin Durham Reg’l Can Ctr Sensenbrenner Hospital - Kapuskasing
Grey Bruce Health Services Campbellford Memorial Hospital St. Joseph’s General Hospital - Elliot Lake
• Royal Cornwall Hospital (U.K.) Hanover & District Hospital Lakeridge Health Temiskaming Hospital - New Liskeard
• Northern Devon District Hospital (U.K.) Huron Perth Healthcare Alliance Northumberland Hills Hospital Timmins and District Hospital
• Asian Breast Centre (Philippines) Listowel Memorial Hospital Peterborough Regional Health Centre West Nipissing General Hospital
• Mary Dow Centre for Cancer Care London Health Sciences Centre Ross Memorial Hospital West Parry Sound Health Centre
Middlesex Hospital Alliance Rouge Valley Health System Northwest at Thunder Bay Reg’l Health
(Maine, USA) South Bruce Grey Health Centre The Scarborough Hospital Sciences Centre
• Tom baker Cancer Centre (Alberta, St. Joseph’s Health Care, London Cancer Centre of Southeastern Ontario Atikokan Regional Hospital
Canada) St. Thomas - Elgin General Hospital Kingston General Hospital Dryden Regional Health Centre
Tillsonburg District Memorial Hospital Hotel Dieu Hospital Geraldton District Hospital
Wingham & District Hospital Brockville General Hospital Hornepayne Community Hospital
These pages explore the layout of each Woodstock General Hospital Perth and Smiths Falls District Hospital Lake of the Woods District Hospital
chemotherapy (chemo) suite, comparing the Juravinski Cancer Centre Quinte Health Care Manitouwadge General Hospital
amount of space each cancer patient has, as Brant Community Healthcare Alliance The Ottawa Hospital Cancer Centre McCausland Hospital (Terrace Bay)
Hamilton Health Sciences Arnprior and District Memorial Hospital Nipigon District Memorial Hospital
well as how much privacy each patient has
Joseph Brant Memorial Hospital Cornwall Community Hospital Notre Dame Hospital (Hearst)
by evaluating how many people are in direct Niagara Health System Deep River and District Hospital Red Lake Margaret Cochenour Mem. Hpl
sightline of the patient during treatment (see Norfolk General Hospital Hawkesbury and District General Hospital Riverside Health Care Facilities (Fort Frances)
Ill. 4.4). There is a very common design St. Joseph’s Healthcare Hamilton The Montfort Hospital Sioux Lookout Meno Ya Win Health Centre
Carlo Fidani Peel Regional Cancer Centre Pembroke Regional Hospital Thunder Bay Regional Health Sciences Ctr
aspect in these five layouts; typically, chairs Halton Healthcare Services Corporation The Queensway Carleton Hospital Wilson Memorial Hospital (Marathon)
are placed around the perimeter of the room, Headwaters Health Care Centre Renfrew Victoria Hospital
all facing the centre where the nurses typically
are located.
ILL. 4.3. There are 115 hospitals in Ontario that offer chemotherapy
35) “Regional Cancer Programs.” Cancer Care Ontario., last

modified Nov 3 2009, accessed Dec 10, 2014, www.cancercare.
on.ca/cms/one.aspx?portalId=1377&pageId=8958.
70 71
EXISTING CHEMOTHERAPY SUITES
ROYAL CORNWALL NORTHERN DEVON ASIAN BREAST CENTRE MARY DOW TOM BAKER CANCER CENTRE
1:100 1:100 1:100 1:100 1:100
5.0m2/patient 5.0m2/patient 6.8m2/patient 7.8m2/patient 2.8m2/patient 4.2m2/patient

21 chairs in total 14 chairs in total 7 chairs in total 10 chairs in total 15 chairs 5 chairs
6 patients within view 5 patients within view 0 patients within view 3 patients within view 9 patients in view 1 patient in view
(curtains open) (curtains open) (curtains open) (curtains open) (curtains open)
United Kingdom United Kingdom Philippines Maine, USA Alberta, Canada
ILL. 4.4. Comparison between five chemotherapy suites from around the world
72 73
GRAND RIVER REGIONAL CANCER and the surrounding areas. The Cancer Centre
CENTRE wing is on the east side of the site, attached
After examining some chemotherapy suites to the main hospital (see Ill. 4.5). It offers
around the world, the thesis now examines specialized care in chemotherapy, radiation
Grand River Regional Cancer Centre therapy, clinical trials, supportive care,
(GRRCC), which opened in 2003, located in inpatient oncology, and palliative care.36 The
Kitchener Ontario. This will be the location chemotherapy suite is located on the second
of the Design Development in Part VII. As floor and can hold approximately 24 patients
a Regional Cancer Centre, it serves residents at one time (see Ill. 4.6).
from the Waterloo Region, Wellington County
KING STREET WEST
P
H
GRAND RIVER REGIONAL CANCER CENTRE
CHEMOTHERAPY SUITE, 2ND FLOOR
1:200
6.0m2/patient 4.6m2/patient 5 patients within view

8 beds 16 chairs
ILL. 4.5. Site plan of Grand River Hospital, Kitchener, Ontario, 1:2000 ILL. 4.6. Evaluating Grand River Regional Cancer Centre’s chemotherapy suite
36) “Cancer Program.” Grand River Hospital., accessed Mar 3,

2015, http://www.grhosp.on.ca/CANCERPROGRAM.
74 75
Many chemotherapy suites become very place every week. The medications often The GRRCC chemotherapy suite was materials are used throughout the space. The
crowded and have little to no privacy (see make patients feel nauseous and weak, while built in 2003. A relatively new space, the space, however, still presents itself as very
Fig. 4.18). Patients spend long hours in the having to sit in one chair for hours in a tense environmental qualities are quite good institutional, with bare white walls and harsh
chemotherapy suite while they receive their environment can be very uncomfortable. compared to many older hospitals (see Fig. bright white lights. It still heavily resembles
treatments. A typical chemotherapy session 4.19). Half of the patients are located near a hospital space, breeding negative emotions
could take several hours and might take windows providing natural light, and wood of fear, anxiety, and worry.
FIG 4.18. Existing chemotherapy suites FIG 4.19. Existing chemotherapy suite at the Grand River Regional Cancer Centre (2015)
76 77
While taking a holistic approach of healing
we must consider environments because
they play such a crucial part in one’s healing.
Traditional hospitals built in the 1800’s had
a much greater emphasis on natural light and
fresh air. Contemporary hospitals built Post-
WWII show a shift in design, placing a high
emphasis on function-oriented design.
Part IV revisited the Maggie’s Centres projects

to study the architectural placebo effect,
which has a positive, calming effect on the
body. Several chemotherapy suites revealed
the crowded and privacy-lacking spaces that
currently exist. Grand River Regional Cancer
Centre in Kitchener, Ontario, was introduced
as the site for Design Development, discussed
further in Part VII.
Part V reviews the focus patient undergoing

chemotherapy and investigates the specific
challenges they face with cancer.
79
N
PART V: CANCER AND THE FOCUS PATIENT

About Cancer and examining patients undergoing chemotherapy
81
ABOUT CANCER
CANCER care. The most common cancers are prostate

Cancer is currently the leading cause of cancer for men, and breast cancer for women
deaths in Canada with a projected estimate of (see Ill. 5.3). The following page describes
77,532 new cases of cancer in Ontario alone1 specific challenges that cancer patients face
(see Ill. 5.1 & 5.2). As the number of cancer during treatment, including the effects of
cases continues to rise, hospitals will need to chemotherapy.
prepare for the growing demand for cancer
ILL. 5.1. Causes of Death in Canada, 2011
Total Population % of pop. Projected new Projected # of

over 50 cancer cases deaths
Waterloo Region 784,778 33% 3,940 1,528

Ontario 13,761,605 36% 77,532 26,760
ILL. 5.2. Stats projected for 2014 ILL. 5.3. Estimated new cases of cancer, Canada 2014
1) “Cancer Statistics.” Waterloo Wellington Regional Cancer

Program., last modified 2014, accessed Apr 4, 2015, www.ww-rcp.
on.ca/cancerstatistics/.
82 83
FOCUS PATIENT UNDERGOING CHEMOTHERAPY
HAIR LOSS Fatigue is the biggest complaint from cancer patients,

Suspicion Due to the killing of all fast topping pain, depression/anxiety and loss of appetite.
of problem growing cells; often has a
CANCER very negative impact on a
FATIGUE patient’s self esteem and FATIGUE
self image
HEALTH LOSS OF BALANCE
TIRED PROBLEMS
Diagnosis DIZZINESS DIFFICULTY HEARING
BLURRED VISION STIFF NECK
NORMAL FATIGUE
SORES IN MOUTH OR
THROAT ABNORMAL BLOOD
Maintenance Causes of fatigue PRESSURE
Treatment • Toxic treatments
• Body repairing itself
• Altered nutrition CHANGE IN APPETITE
• Altered sleep cycles Cancer treatments often
alters eating habits, DIARRHEA OR
• Stress
sometimes causing nausea CONSTIPATION
Recovery • Travel
• Emotional distress or the need to eat more than
normal which may lead to
bloating
ILL. 5.4. Typical cycle for patients ILL. 5.5. Cancer Fatigue
receiving chemotherapy (typically
cancer patients)
ACHY MUSCLES
After diagnosis, patients usually begin Cancer Fatigue is one of the most difficult NEUROPATHY
(Numbness and pain in
treatment immediately, which can last challenges cancer patients face and is not hands and feet caused
anywhere from two months and beyond often treated because it cannot be directly by nerve damage)
depending on the severity of the disease, measured, and patients often do not bring it
prognosis, and progress as treatment takes to the attention of their caregivers.2 Among
place (see Ill. 5.4). The treatment plan can other symptoms such as nausea, dizziness,
change significantly as time progresses. and hair loss (see Ill. 5.6), cancer fatigue,
Unfortunately, many cancer patients recover more severe than regular fatigue, tends to
only to find the cancer has spread. At this get worse with more chemo and radiation
time, they typically resume treatment, either treatments (see Ill 5.5). How many of these
similar or different from before. Treatments symptoms and deaths could be avoided by
widely vary by person and by stage. minimizing stress from healing spaces?
ILL. 5.6. Common Symptoms of Chemotherapy
2) Evans, Dr M. “Cancer Related Fatigue.” Sunnybrook., accessed

Nov 1, 2014, http://health.sunnybrook.ca/cancer-fatigue-content/
video/.
84 85
ANIXETY HIGHANXIETY
Treatment
M M SU M
SU T T
SU SA
SA
T W W
TYPICALTREATMENT CYCLES
F F
Cancer treatment plans vary depending
on the patient’s specific condition and TH TH
disease. The following three examples SA TH TH
(see Fig. 5.7, 5.8 & 5.9), were taken W F F
from an example patient with Locally W W
SA SA
Advanced Inflammatory Breast Cancer. F T T
TH SU M SU
A combination of chemotherapy, M
radiation, and injections are often used
in 7 or 14 day cycles that repeat for
several months.
ILL. 5.7. 7-DAY TREATMENT CYCLE ILL. 5.8. 14-DAY TREATMENT CYCLE ILL. 5.9. 14-DAY TREATMENT CYCLE
Chemotherapy/Radiation (x12 Repeat) Chemotherapy, Neupogen (x8 Repeat) Chemotherapy, Neulasta (x8 Repeat)
INJECTIONS (Home)
CHEMOTHERAPY (Hospital) Injections are administered to chemotherapy patients in between chemotherapy
Chemotherapy is a treatment for cancer by the use of powerful chemicals injected treatments to help the body restore itself after the harsh effects of the chemotherapy
into the body via intravenous to kill fast-growing cells in the body. drugs destroy important systems needed for the body’s recovery.
NEUPOGEN® (FILGRASTIM)
RADIATION THERAPY (Hospital) Neupogen is used to treat neutropenia, a condition where the body makes too few
HOSPITAL
Radiation therapy uses high-energy radiation to shrink tumors and kill cancer cells. neutrophils, a white blood cell important in the body’s fight against infection.4
HOME
X-rays, gamma rays, and charged particles are types of radiation used for cancer
treatment. It is commonly delivered by a machine outside the body (external-beam NEULASTA® (PEGFILGRASTIM)
radiation therapy).3 Neulasta’s use is similar to Neupogen but the different medications are used in
different combinations depending on the specific chemo treatment a patient is
TESTS / DOCTOR’S VISIT (Hospital) receiving.
Various tests must be performed throughout cancer treatment to monitor the body’s
conditions, including blood levels, heart conditions, and scans to determine cancer REST DAY (Home)
growth, among other things. No treatment unless problems arise.
3) “Radiation Therapy for Cancer.” National Cancer Institute., last

modified June 30, 2010, accessed January 9, 2015, http://www.
cancer.gov/aboutcancer/treatment/types/radiationtherapy/radiation- 4) “Neupogen.”, last modified 2014, accessed Nov 1, 2014, http://
factsheet www.neupogen.com/.
86 87
SAMPLE TIMELINES the disease. Ill. 5.10 shows sample timelines white-blood-cell counts from treatments), patients who are frequently at the hospital, and
Cancer treatments alone often cause a great for a typical day as a cancer patient, an and a typical day for a healthy person who they suffer from uncomfortable symptoms
deal of damage to the body. This creates a lot atypical day as a cancer patient (when a is not undergoing cancer treatment. Stress from the medications. This weaker condition
of stress on top of the stress of dealing with blood transfusion is needed due to low, and anxiety levels tend to be much higher in makes it harder to cope with this stress.
TYPICAL:
Anxiety Level
Anxiety Level
MRI scan
Chemo
Doctor
6am 12pm 6pm 6pm 12am 6am

P
AN
P
IN
AW
O
U
EE
TO
EM
E
C
K
R
SL
AK
C
IS
EC
H
D
O
C
R
W
D
H
D
M
O
C
O
BL
Anxiety Level
Anxiety Level
ATYPICAL:
Blood Draw
Transfusion

R BL F UR
IN
P
AW
SI NS D
FU A OD
EE
FU A O
U OD R
O -
O -
K
AI HO
SI NS
TR LO
TR L O
R
ES O O
EC
SL
N
N
D
B
W 2
S
H
LT
C
O
O
BL
Anxiety Level
Anxiety Level
HEALTHY
PERSON
P
TV
D LK
R ER
AX
RK
RK
P
O CH
EE
EE
TY
G
A
EL
PA N
T
H
O
O
N
W
O
SL
SL
IN
U
C
W
R
LU
AT
D
W
ILL. 5.10. Comparing Schedules and Anxiety Levels: Chemo Patient vs.
Healthly Person
88 89
TIME
BLOOD
BLOOD CHECK IN DRAW
DRAW
TIME
WAIT
MRI
DOCTOR WAIT
DOCTOR WAITING TIME
MRI WAIT WAIT
WAIT BLOOD WAIT Much of a patient’s time at the hospital is
CHECK IN TIME
WAIT
DRAW
MRI WAIT
WAIT
DOCTOR spent waiting. Ill. 5.11 explores the different
WAIT
CHECK IN WAIT
TIME
BLOOD phases patients experience during a visit to
CHEMO DRAW DOCTOR
CHEMO WAIT
MRI WAIT the hospital and compares the amount of time
BLOOD WAIT
CHECK IN DRAW WAIT spent
DOCTOR
in each portion, as well as the typical
Anxiety Levels Time Spent CHEMO MRI
pent WAIT
WAIT
WAIT anxiety levels associated with each period. Ill
TIME
Low Anxiety Short CHEMO
WAIT 5.12 maps out where each of these stages are
Short Anxiety Levels Time Spent
BLOOD
TIME
located in the Grand River Regional Cancer
CHECK IN DRAW
Low Anxiety
WAIT
High AnxietyShort Longer MRI WAIT
Indicates Significantly High Anxiety or Time
Anxiety Levels
DOCTOR
Time Spent CHEMO Centre. Often, patients will have several
Longer TIME BLOOD
WAITor Time
Indicates Significantly High Anxiety
WAIT CHECK IN DRAW appointments
DOCTOR
in one day, including tests,
MRI WAIT
High Anxiety
CHECK IN Longer
BLOOD Low Anxiety
Anxiety Levels Short
Time Spent
WAIT
WAIT treatments, and doctor examinations, yet
DRAW Indicates Significantly High Anxiety or Time DOCTOR
WAIT
MRI WAIT most waiting spaces neglect to meet the need
WAIT
WAIT CHEMO Low Anxiety
High Anxiety Short
WAIT Longer Indicates Significantly High Anxiety or Time for patients to heal. Even while receiving
CHEMO chemotherapy treatments via intravenous,
nxiety Levels Time Spent High Anxiety Longer
CHEMO
Indicates Significantly High Anxiety or Time patients sit and wait for several hours while
Low Anxiety Short Anxiety Levels Time Spent the treatments takes its course.
“
ILL.Levels
Anxiety 5.11. Time and
Time Role of Patient
Spent Low Anxiety Short
High Anxiety Longer
Waiting time could be used in an effective
Low Anxiety Short An old-fashioned ladies’ room – not way to help people heal, emotionally and
High Anxiety Longer
IndicatesaSignificantly
partitioned Hightoilet inoraTime
Anxiety row
– with its psychologically from one treatment, while
„
High Anxiety Chemo
Longer
Indicates Significantly High Anxiety or Time own hand basin and a proper door in they gear up for the next. Natural light and a
Wait
Doctor a door frame – supplies privacy for view of plants and birds offer the opportunity
crying, water for washing the face, to relax and temporarily take one’s mind off
Blood Draw
and a mirror for getting ready to deal the immediate worries. An inviting space
with the world outside again.5 that calms the worried mind could offer
Wait
opportunities for people to talk and lean on
MAIN - Maggie Jencks each other for support.
HOSPITAL
MRI
Check In
Wait
ILL. 5.12. Axo, Grand River Regional Cancer Centre 5) Jencks, Maggie Keswick. 1995. A View from the Front Line:
Marcia Blakenham. 21.
90 91
There is an enormous prevalence of cancer in
Canada, and the disease is currently the top
cause of death. One of the many challenges
cancer patients face is fatigue, yet many
hospitals do not address this concern in their
design. Waiting rooms are uncomfortable,
and patients spend long days at the hospital,
adding to their discomfort and fatigue.
The thesis has reviewed a variety of healing

spaces, including many which showed
positive health impacts. Part VI now outlines
the space in which the design proposals take
place for cancer patients: the chemotherapy
suite at Grand River Regional Cancer Centre.
The design proposals aim to test a variety of
strategies to address these questions: how
can architecture of a healing space become
an integral part of healing itself? How can
architecture have an active role in the healing
process?
93
PART VI: INTERVENTION SITE
Identifying opportunities for interventions
95
IDEAL VS. PRACTICAL
FOREST SETTING URBAN SETTING

Natural Built up
+ =
Ideal setting to maximize Logical location for a healing
potential for psychological centre, accessible to many Thesis focus
healing
Trees release Soft ground Natural light Artificial lights People and Sign pollution
phytoncides, cover absorbs controls produce eternal vehicles can be
lowering brain noise circadian day (Philippe produce distracting and
ILL. 6.2. Thesis Focus
activity rhythm Rahm) disturbing stressful
noises
An ideal healing space would incorporate can contribute to the treatments and needs of
many natural elements: trees releasing a patient in such a way to not only facilitate
phytoncides, soft ground cover absorbing but to also enhance the healing process.
noise, and natural light. For practical reasons, Architecture can act as a placebo, holding
hospitals are often built in dense urban healing qualities in the nature of the design
locations for easy access and to be in close itself.
proximity of other hospitals and resources
needed for their medical care (see Ill. 6.1). The focus of this thesis is to determine how
to blend the aspects of an ideal setting with a
How can a healing space balance the need logical location, typically, far removed from
for medical equipment and still be able natural surroundings (see Ill. 6.2). The two
to integrate design strategies to tap into key elements of interest are coloured light
the senses and the body’s natural healing and scent.
abilities? The architecture of a healing space
ILL. 6.1. Comparing elements of a forest to an urban centre
96 97
HOSPITAL INTERIOR ARCHITECTURE
Goals of a healthcare facility include Light is extremely important in a hospital.

balancing the emotions of those who come Daily light patterns affect the circadian Donald McKahan, an architect and Health
for treatment. Healthcare architecture should rhythm, which is the body’s way of keeping Facility Planner, further explores what makes CONTROL
provide protection and privacy, security and track of day and night. The circadian rhythm people feel uncomfortable in hospitals. A
independence. Patients need to feel cared for also regulates body temperature, heart beat, survey showed that a patient’s greatest fear
yet, not trapped, connected to people while hunger, and sleep.3 When a patient is in a is sleeping in the same room as a stranger. As ILL. 6.3. Hospitals and prisons both
also having their own personal space. hospital ward where there are no windows previously mentioned, multiple-occupancy have one things in common: lack of
and the lights are always on, it is disorienting rooms are prone to more noise and lack control.
Healing gardens have many benefits, and to the body, as it cannot tell when the cycle privacy. Erie Chapman, CEO of Riverside
when they cannot be incorporated into of day ends and night begins. Prolonged time Hospital in Ohio, finds many similarities distract people from seeing the many studies
a design, plants, water and other natural in environments such as these can lead to between hospitals and prisons (see Ill. 6.3). that show how advantageous EBD can be
elements with restorative qualities can take depression which compromises the immune In both facilities, patients and inmates are and that results can be measured by patients’
their place. Hospitals are often disorienting system. Sunlight is extremely important for given a number, assigned a uniform, put stress responses, personal mood, and rate
and confining. Patients are often under a the body. In addition to helping stabilize the into a room, often bleak and white, usually of recovery. Good design must consist of
constant reminder of their illness with the circadian rhythm within the body, the body given a “cell-mate,” and handed limited food a combination of art and science. Success
various protocols and equipment. Plants also needs vitamin D which is absorbed choices. In both scenarios, people are stripped is based on craft being paired with strong
(especially entire gardens) reduce the feeling through the skin and helps promote bone of their freedom and control. “Hospitalization research.8 Architect Anne Underhaug states,
of isolation.1 formation, aids the immune systems, and radically alters the contacts and the context “People need to look out, they need daylight.
boosts one’s mood.4 of patients’ daily lives,” McKahan remarks.6 You don’t need a book on evidence-based
In a study at the Graduate School of design to know that.”9
Horticulture in Chiba Uni, Kazuko Koga and In addition to providing patients with proper There is much evidence to suggest that
Yutaka Iwasaki studied the effect on humans light, it is extremely important that they people’s comfort and happiness have a great WHERE CANARCHITECTURE OFFER
when touching foliage. They showed that feel comfortable which often translates into effect on their ability to cope and ultimately HEALING?
people experience an unconscious calming having enough privacy. Single occupancy recover faster. Key studies led by Roger To explore where hospitals can offer the most
reaction when touching a plant. In contrast, rooms are more expensive and take up more Ulrich have shown that pleasant views and beneficial healing spaces, an examination
metal stimulus caused a stress reaction in space but they have many positive effects on connection to nature not only have positive is presented on the following page. Ill. 6.4
human cerebral blood flow.2 people’s psychological, mental, and physical impacts on patients, but on staff and visitors as presents questions to further the discussion
health. Private rooms reduce unwanted noise well. Now that these types of Evidence Based on the critical points in a patient’s hospital
Hospitals have a lot of metal surfaces for and provide an environment that patients Design (EBD) studies are becoming widely visit, where stress levels are frequently at
sanitary reasons; metal is easier to clean have more control over. Noise from people available, architects have a responsibility to their peak. Ill. 6.5 maps out the phases of
than many other materials. It seems that is talking, nurses walking in the hallways, act on this knowledge. Knowledge creates the typical visit to the hospital, illustrating
the main driving force when designing the announcements over the intercom can disturb a moral obligation.7 Some people believe how much travel is required to move to each
hospital, but if it creates a stress reaction in sleep, raise blood pressure, slow wound that EBD is so complicated that it is not appointed space. Patients are often extremely
patients, is this not creating a problem while healing and, ultimately increase one’s length possible to design based on how people feel. exhausted, and traveling and way-finding can
solving another? of stay in the hospital.5 Logistics, time, money, and location often be overwhelming.
5) Ibid.
1) Komiske, Bruce King. 2013. In Designing the World’s Best 6) McKahan, Donald. “Healing by Design.” Sandow Media
Children’s Hospitals 3. 3rd ed., 187: Images Publishing Dist Ac. 3) Hazlewood, Kelsey. “Light, Color, Sound.” College of Design and LLC, last modified 1993, accessed Oct 14, 2014, http://www. 8) Ibid. Page 267.
2) Koga, Kazuko and Yutaka Iwasaki. 3013. “Psychological and Walter Cronkite School of Journalism and Mass Communication, interiordesign.net/. 9) Rosenfield, Karissa. “Can Well-Designed Hospitals Shorten
Physiological Effect in Humans of Touching Plant Foliage ¬ using Arizona State University, last modified 2008, accessed Oct 12, 2014, 7) Hamilton, Kirk. 2006. “Evidence Based Design and the Art Recovery Times?” Arch Daily., last modified Nov 25 2014,
Semantic Differential Method and Cerebral Activity as Indicators.” http://cronkitezine.asu.edu/healing/environments/banner.html. of Healing.” In The Architecture of Hospitals, 271-280: NAi accessed Dec 29, 2014, http://www.archdaily.com/572185/can-
Journal of Physiological Anthropology. 4) Ibid. Publishers. well-designed-hospitals-shorten-recovery-times/.
98 99
WHAT HAPPENS DURING TESTS? WHAT HAPPENS IN BETWEEN
How does the body deal with stress TREATMENTS?
during a test that may perhaps be How does the body handle stress and how does
painful or uncomfortable? How does the body prepare for the upcoming treatments?
the body respond to the anxiety of Esther Sternberg writes about the importance of
anticipating the results? Tests are relaxation in order to open up the body to accept
often very complicated, and patients much needed treatments and medication to
1. Entrance 2. Check In 3. Elevator 4. Elevator
can become especially worried when maximize healing potential.
they do not understand what is going
on, and what certain things mean to
their health.
TIME
BLOOD
CHECK DRAW 5. Wait 6. Blood Draw 7. Elevator 8. Elevator
MRI DOCTOR
IN WAIT WAIT
WAIT
WAIT
CHEMO

WHAT HAPPENS DURING LONG WHAT HAPPENS AFTER MEDICAL
9. Wait 10. MRI 11. Elevator 12. Elevator
TREATMENTS? TREATMENTS?
Chemotherapy through intravenous What happens at the end of a
can take anywhere from 30 minutes patient’s day at the hospital? A stress
to four hours to administer. How do response can be measured for hours
patients manage the psychological after a stressful event. Just because
stress of these chemicals damaging a patient has finished receiving
one’s body and the physical symptoms chemotherapy does not mean their
of the drug itself? body has recovered from the stress the
experience generated. A patient needs
a ‘buffer zone’ after treatment to fully
recover from the day. 13. Wait 14. Chemo 15. Wait 16. Doctor
ILL. 6.4. Where Architecture can offer Healing?

ILL. 6.5. (Opposite page) Areas visited at the hospital during typical visit
17. Pharmacy 18. Elevator 19. Elevator 20. Depart
100 101
The goal of this thesis is to translate as many
of the advantages of the ideal healing setting
into the design of modern hospital spaces.
This final part explores the design

development and intervention proposals
which aim to address the challenges of the
chemotherapy suite. The design development
will focus specifically on the chemotherapy
suite at Grand River Hospital. The designs
seek to help augment healing through
environmental elements, by supporting the
body’s natural abilities to release immune
boosting brain pharmaceuticals. Assessments
are conducted to evaluate the success of
the designs, including their strengths and
weaknesses. Additional spaces outside the
chemotherapy suite are also examined to
address some of the questions raised in Part
VI, and to explore how these design systems
can be integrated throughout a hospital.
103
PART VII: DESIGN DEVELOPMENT
Responding to the needs of cancer patients and proposing interventions
105
DESIGN DEVELOPMENT GOALS
Part VII explores three design development typically get people coming only once.
iterations. In order to begin design work, Hospitals, on the other hand, have many
EXPERIMENTAL MEDICAL USE
Project was designed for
objectives were established by referencing patients visiting over and over and require
Space is used for specific
experimental reasons medical purposes many of the influential projects reviewed different stimulating elements to keep the
to test effects or space throughout the thesis. In order to better experience fresh.
qualities evaluate and compare projects to one another,
SITE DEPENDENT
evaluation guidelines were determined. Single sense used vs. multiple senses
NON-SITE SPECIFIC
Project requires specific Project can operate in The assessment presented in the Design used: Projects will often aim to stimulate a
site in order to operate multiple sites Development Evaluation Guidelines (see particular sense (hearing, seeing, touching,
effectively Ill. 7.1) indicate the intentions for the design tasting or smelling) and some projects aim to
intervention. The following page shows a stimulate more than one.
LONG TERM EXPOSURE
comparison of key projects, evaluating them
INSTANT
Effects on people Goal of architecture according to these sliders. Low cost vs. high cost: Projects will vary
0 min 30 min 60 min+
happen instantly when in becomes effective over in the expenses they require to set up and
space longer periods of time EVALUATION CRITERIA operate.
(multiple uses) Experimental vs. medical use: Evaluates
SINGLE USE
projects based on their purpose. Many Single user vs. multiple users: Some projects
MULTIPLE USES
Project intended to be Project intended to be projects are studies or installations that are are intended for one user at a time in the space,
0 5 10+
used once per user used repetitively experimental in nature; others were designed whereas others will be designed for multiple
for a medical facility use. people using it at the same time, including
patients, nurses, doctors, and visitors.
SINGLE SENSE USED MULTIPLE SENSES Site-dependent vs. non-site specific: Some
Project stimulates one Project stimulates five projects are highly dependent on their site in EVALUATIONS
0 5
sense senses order to function properly, while others can be The evaluations on the following page analyze
placed anywhere without any disadvantages. some of the significant projects mentioned
previously in this thesis (see Ill. 7.2 & 7.3).
LOW COST HIGH COST Instant vs. long-term exposure: Some projects This provides a method of contrasting and
Project requires $ $$$ Project requires relatively affect the user instantly, such as a calming comparing projects with each other and
relatively low cost to high cost to install and walk through a forest, whereas other projects with the intended evaluation criteria set out
install and operate operate require longer periods of time in order for the for the design development of the proposed
full effect to sink in. chemotherapy suite. Projects are grouped
SINGLE USER MULTIPLE USERS as those that are experimental in nature and
Project affects one user 0 10 20+
Project accommodates Single use vs. multiple use: Projects are those with specific medical uses.
at a time several people in one typically designed to either be visited once
space or multiple times. Installations, for example,
ILL. 7.1. Design Development Evaluation Guidelines
106 107
Experimental Medical Use Experimental Medical Use
HARMONORIUM Experimental Medical Use DYSON CENTRE Experimental Medical Use

Biennale Pavilion Site dependent Non-site specific Neonatal Unit Site dependent Non-site specific
Instant Long Exposure Instant Long Exposure
Senses: Single use Multiple uses Senses: Single use Multiple uses
Single sense Multiple senses SEE Single sense Multiple senses
SEE, SMELL
Low Cost High Cost Low Cost High Cost
Single user Multiple users Single user Multiple users
SPLIT TIME CAFE Experimental Medical Use HUMBER RIVER HOS. Experimental Medical Use
Cafe Proposal Site dependent Non-site specific Permanent Site dependent Non-site specific
SEE Single sense Multiple senses SEE, FEEL, HEAR Single sense Multiple senses
NOCTI VAGUS Experimental Medical Use CENTRE FOR CANCERExperimental Medical Use
Dark Restaurant Site dependent Non-site specific Permanent Site dependent Non-site specific
NO SIGHT Single sense Multiple senses SEE, FEEL Single sense Multiple senses
FOREST BATHING Experimental Medical Use MAGGIE’S PLACE Experimental Medical Use
Walk in forest study Site dependent Non-site specific Permanent Site dependent Non-site specific
SEE, SMELL, HEAR, Single sense Multiple senses SEE, FEEL, HEAR Single sense Multiple senses
FEEL Low Cost High Cost Low Cost High Cost
LIGHT THERAPY Experimental Medical Use SENIOR RES. Experimental Medical Use
Bus Stop, Sweden Site dependent Non-site specific Permanent Site dependent Non-site specific
SEE Single sense Multiple senses SEE, FEEL Single sense Multiple senses
ILL. 7.2. Project Evaluations - Experimental Projects ILL. 7.3. Project Evaluations - Medical Projects
108 109
OBJECTIVES FOR DESIGN
DEVELOPMENT
ADAPTABLE ADAPTABLE
In order to address the needs of each
The following three objectives are outlined to per patient chemotherapy patient, the design should
address the specific needs of the chemotherapy be adaptable for each patient. People come
suite and its users in the design developments into the hospital for treatment with many
to follow. different needs and tolerances. Some people
desire to be social while being awake and
alert throughout their treatment. Other people
may feel ill or prefer more privacy and would
rather have a nap during treatment. People’s
needs can change person to person and day
to day, and the design of the space should be
able to accommodate and address a variety of
needs at the same time.
FLEXIBLE FLEXIBLE
There are approximately 115 hospitals in
for installation in any chemo suite Ontario that offer chemotherapy. While a
new design approach for chemotherapy
suites would be beneficial to aid the design
of brand new facilities, there is a need for
existing chemotherapy suites to be retrofitted
in order to improve the quality of care at these
hospitals. Therefore the following design
development has an emphasis on flexibility
for installation in existing chemo suites.
LOCALIZED LOCALIZED
As mentioned previously, every patient has
effect to be controlled to affect unique needs for designs incorporating scent
intended patient and light, the effects must be controlled so
as not to interrupt treatment spaces for which
they are not intended.
110 111
INTRAVENOUS Pharmacy Wait
Intravenous is the common method of receiving chemotherapy. Doctor
A needle is placed in a patient’s vein, and the entire session Chemo (Doctor)
can last up to 4 hours. Wait
(Blood
Draw)
UPPER
CHAIR
While a patient receives chemotherapy, they need a place to sit
for the duration of the treatment. They may get up periodically
to use the bathroom. MRI Scan
(Main Hospital)
Approx. size: 1m (H) x 0.8m (W) x 0.9m (D)
Wait
Blood
Draw
MEDICAL CART Entrance
Nurses often use a medical cart to move around equipment
needed for chemotherapy. This cart generally holds needles,
blood pressure and heart pulse monitors, and any extra Lobby
bandages or cotton.
Approx. size (varies): 0.85m (H) x 0.5m (W) x 0.4m (D)
ILL. 7.4. Elements required for chemotherapy
REQUIREMENTS FOR CHEMO the chemotherapy suite can be very flexible GROUND
The treatment of chemotherapy typically in its design while still accommodating
requires very little medical equipment in the the necessary equipment. At Grand River
chemo suite (see Ill. 7.4). Each patient needs Hospital, patients often have many other
a chair and an IV pole for the medication. appointments before and after chemotherapy,
Medical carts are used by nurses to move their and these are generally located throughout
supplies around. With such few requirements, the cancer centre (see Ill. 7.5).
ILL. 7.5. Schematic Axo, Grand River Regional Cancer Centre
112 113
DESIGN DEVELOPMENT PROPOSALS DESIGN 1: WILE WALL
Three design iterations have been proposed The Wile Wall introduces natural plants into the
with the purpose to address the challenges chemotherapy space, contained within a wall
of stress and cancer treatment in the hosting multiple compartments for different
chemotherapy suite, discussed throughout plants. Sliders allow patients and hospital
this thesis. All iterations focus on using staff to close or open the compartments to the
the elements of coloured light and scent to treatment space, allowing the scent from the
stimulate a stress reduction in patients. These intended plants to be drawn out of the wall
proposals act as mini studies to further advance and into the area where the patient is situated.
the conversation around how hospital spaces
can be improved to aid healing. Each of these The multiple compartments allow for
proposals were designed one after the other, flexibility for a variety of plants to be
each successive design trying to capitalize available for treatment. Plants could include
on the previous design’s strengths, while peppermint, which helps fight fatigue,
attempting to improve the overall scheme in lavender, which acts as a sedative, rosemary,
terms of effectivity, logistics and practicality. which helps with alertness and jasmine,
which has a scent that is very calming.
ELEMENTS IN CHEMOTHERAPY
SUITE
The following pages examine elements used
in the Wile Wall Chemo Suite Design (see Ill.
7.6) as well as the scents that could be used in
the wall itself (see Ill. 7.7).
114 115
Glass screens WILE Wall
Sliding glass screens operate to either expose plant The wall houses various types of plants that each give
fragrances in the Wile Wall into the treatment area or to off a fragrance that directly has an effect on the brain’s
block the scent from each individual compartment. When chemical processes to produce an effect in the body to
the lavender compartments are “open,” the peppermint aid in the comfort and healing process taking place during
compartments are “closed,” and vice versa. chemotherapy.
Glass
Lavender Transparent glass covers water, allowing a visual connection
50% of the plant matter in the Wile Wall is lavender. through to the water and the colour produced by the light.
Lavender has been known to act as a sedative showing
relaxing effects by slowing reactions, reducing attention,
and impairing working memory. A study conducted by Dr.
Mark Moss found that residents in a Japanese nursing
Water
Water allows the light from the LED strips to pass through
home who wore a lavender skin patch suffered fewer falls.
and create a natural reflection on the wall. The water also
Researchers speculate that lavender has a stabilizing effect
carries the colour of the light to project onto the wall surface.
on balance (see Ill. 7.7 for study sources).
As water drains through plant material and empties into the
trough below, reflections of these ripples are projected onto
the wall and ceiling.
Peppermint
50% of the plant matter in the Wile Wall is peppermint.
Peppermint has been known to help fight driving fatigue,
as found in a study by Dr. Bryan Raudenbush at Wheeling
Lights
Light fixtures located within the water produce coloured
Jesuit University (see Ill. 7.7 for study sources). light to be projected onto the wall.
Colour
ORANGE: With a wavelength greater than 570 nm, orange
Intake vent will trigger the release of melatonin, making the body
perceive the time as true night, feeling tired.
A vent drawing air in is placed on the floor behind the
chemo chair, directing air from the plants in the wall to the
BLUE: With a wavelength less than 570 nm, blue will block
vent, passing by the chair and hence the patient, spreading
the release of melatonin making a patient feel more awake.
the fragrance of the plant onto the user.
ILL. 7.6. Elements used in Wile Wall Design
116 117
LAVENDER Lavender has sedative effects, slows
SEDATIVE reactions, reduces attention and impairs
Arrangement 1
working memory.1
Wile Wall
PEPPERMINT Peppermint (and cinnamon) both fight driving
FIGHTS FATIGUE fatigue.1
60cm
CUCUMBER PERCEPTION OF 75% of claustrophobic volunteers felt better
SPACE about being in an elevator.1
PEPPERMINT LAVENDER
Frankincense has immune boosting features Helps fight fatigue Sedative
FRANKINCENSE IMMUNE BOOSTING
and has been used to help heal soldiers after
battle.2
ORANGE When exposed to scent, violent criminals

RELAXING (2008) were less aggressive, had fewer fights,
were calmer and needed fewer sedatives.1
120cm
ROSEMARY Smelling rosemary produces beta brain waves
ALERT which demonstrate alterness.1
Arrangement 2
Wile Wall
JASMINE Jasmine improves hand-eye coordination in
CALMING cases as diverse as classical violinists and
doctors performing micro-neurosurgery.1
APPLE REDUCES BLOOD Scent reduces systolic blood pressure (peak

PRESSURE pressure) by an average of 3-5 points in ROSEMARY JASMINE
volunteers under stress.1 Alert Calming
ILL. 7.7. Natural Scents
1) Bateson, Lynne. “Smells to make You Well.” Daily Express Health.

Daily Express Health RSS, last modified Dec 4 2012, accessed Sept
18, 2014, http://www.express.co.uk/lifestyle/health/362320/Smellsto-
makeyouwell.
2) Sternberg, Esther and Tippett, Krista. “Esther Sternberg - the
Science of Healing Places.” On Being, last modified 2013, accessed
Sept 17, 2014, http://www.onbeing.org/program/the-science-of-
healing-places/4856/audio?embed=1.
118 119
MEASURING STRESS the common carotid artery and the popliteal
Superficial temporal artery Various techniques can be used to evaluate artery to measure stress reactions (see Ill. 7.8,
Facial artery one’s stress reaction by measuring their 7.9, 7.10 & 7.11). The chair will wirelessly
breathing, heart rate, and blood pressure. send signals to the Wile Wall to set the
Common carotid artery Below is a proposed chair with the ability appropriate scent and colour to be released
to detect specific points in the body, such as for the patient in order to promote calming.
Axillary artery
Brachial artery
Radial artery Peppermint

Helps fight fatigue
Femoral artery
Popliteal artery Blue
(behind knee) Makes the patient feel more
awake.
Dorsalis pedis artery Posterior tibial artery

ILL. 7.10. Environmental elements help patient stay awake.
ILL. 7.8. Arteries in the human body that can be used to measure pulse, an
indication of the body’s stress level.
Lavender
Sedative
Stress detector
The chair in which patients sit during chemotherapy will
be able to monitor their pulse as an indication of their
stress response. This information can be relayed back
to the doctors, as well as to the system that controls the Orange
treatment area (the colours and scents). Makes the body feel tired.
ILL. 7.9. Stress detecting chair ILL. 7.11. Environmental elements help patient fall asleep.
120 121
DOPAMINE
MELATONIN
MATERIALITY
MORPHINE
ILL. 7.12. Wile Wall releases natural chemicals to help reduce stress.
WILE WALL healing. Different plants release different

“Wile” is a noun which means to trick or chemicals and can be very effective in terms
fool, trap or entice. As traditional drugs such of making a person feel calmer, alert, less
as morphine are potentially harmful and claustrophobic, less aggressive, fatigued,
addictive, plants can replace the need for more awake, or boost the immune system,
drugs by encouraging the body to release depending on the specific scent and plant (see INNER WORKINGS
certain chemicals in the brain to augment Ill. 7.12). ILL. 7.13. Structure of the Wile Wall
122 123
4m
45-60cm Reflection of water and

colour from below
2.5m
Glass panel blocks

plants not needed for
fragrances
Water
drains
through soil
from one Fragrances from plants
Patient view
plant to in wall being directed
cone
another past patient to vent
60cm
60cm
Vent
Coloured LED strip lights
Water drains into pool creating movement in
water and thus the reflections
ILL. 7.14. Proposed Plan, 1:100 ILL. 7.15. Proposed Section, 1:50
The Wile Wall encourages both flexibility in nowhere else to look except to stare at another on the wall and ceiling. The compartments Certain colours will promote different
the plant and scent selection that each patient patient across the room. The Wile Wall has are perforated at the bottom to allow water to reactions in the patients, and the colour can
is exposed to and offers a stimulating element individual compartments with operable doors drain to below. This water eventually makes be changed depending on the patient’s needs.
to focus on while undergoing treatment (see to contain plants. Each patient has control its way through to a trough at the bottom (see The following page illustrates the view a
Ill. 7.14). Many chemotherapy suites are laid over what plant scents they prefer. Coloured Ill. 7.15) and a coloured light will project the patient would experience within this setting
out in configuration that leaves patients with light and the water reflection can be viewed water reflections onto the wall and ceiling. (see Ill. 7.16).
124 125
ILL. 7.16. Patient’s view of the Wile Wall during treatment
126 127
DESIGN 2: SCENTCUBATOR 5000
While the Wile Wall showed design strengths,

its weaknesses include its large size and
inability to be installed into existing spaces,
as well as its lack of control over the scents
from plants in the wall.
The Scentcubator 5000 addresses these

weaknesses by introducing a self-contained
treatment chair that is better able to contain
scent and light. Its size also allows it to be
moved and installed into existing chemo
suites, taking up no more room than a standard
recliner chair currently used in most spaces.
In this design, plants will be placed below

the seat, and tubes will draw the scent up
into the seating area, while coloured light
is projected on the inside of the roof of the
shell. The plants sit on removable trays and
can be changed between treatments to suit
the individual needs of each patient. Vents
on the side of the chair draw the scent back
into the chair to contain the effects. The roof
is adjustable, allowing patients to choose
privacy or be more visually connected to the
room.
129
SCENTCUBATOR 5000, INNER
WORKINGS
Tubes to carry scent from
plants into Scentcubator The Scentcubator 5000 holds plants of the
patient’s choosing below the patient’s seat
and draws the scent up through tubes in the
Adjustable roof element backrest, dispersing the scent throughout the
shell of the chair (see Ill. 7.17 & 7.19). Scents
from the chosen plants in the chair will have
differing effects on the patient. The patient
can also choose to not have the scent released
Air dispensers / into the Scentcubator.
coloured led light bulbs
Coloured light is projected onto a slightly
reflective surface when the roof of the chair is
lowered (see Ill. 7.18). Colours such as blue
Glass around plants
and purple block the release of melatonin in
the brain and help people feel more awake.
Lavender plants
(sedative effect) Colours such as yellow and orange promote
the release of melatonin in the brain, making
ILL. 7.18. Coloured light fills the
the patient feel tired and helping them sleep.
Scentcubator to reduce patient stress.
The combination of scent and colour are
controlled to address the needs of the patient,
whether they need help sleeping, calming, Scentcubators create. The following page also
relaxing, or staying awake. Fig. 7.20, 7.21 evaluates the advantages and disadvantages
and 7.22 on the following page illustrate, of the elements of coloured light and scent in
in plan and perspective, the atmosphere the the chemotherapy suite.
Dirt and growing
medium for plants
Swivel base for

rotation to control
privacy
Peppermint plants
(alertness effect)
ILL. 7.17. Axo of Scentcubator ILL. 7.19. Top of Scentcubator extends to suit needs of patient, and scent travels
from plants through tubes into Scentcubator.
130 131
ILL. 7.20. Chemo Suite (South side) with Scentcubators
ILL. 7.22. Plan of Chemo Suite (South side) with Scentcubators, 1:150, shows
how each scentcubator can be personalized with light and scent to suit patient’s
specific needs
COLOURED LIGHT SCENT

Easy to control Natural (no poison / overdose risk)
- on/off switch
- dimmer Easily accepted by body
- walls/curtain
- variety of colour Large variety of plants and
corresponding effects on body
No chemical odors or poison
inhalation Great potential to enhance immune
systems and to work with medications
Must be carefully designed to reach Hard to control where scent travels to

ILL. 7.21. Chemo Suite (South side) with Patient Activity maximum potential ensure it stays localized
132 133
DESIGN 3: VERTICAL GARDENS
The Scentcubator 5000 addressed some of the

weaknesses of the Wile Wall. However, with
the plants being placed below the patient,
it loses the visual connection between the
patient and the living foliage.
Plants represent much of what patients are

looking for in themselves during treatment:
growth, renewal, life, cycle, and healing.
Plants have the power to instill hope in
people.
The vertical gardens take the plants

component of the Scentcubators and bring it
to the centre attention of the chemo suite by
introducing several self-contained vertical
gardens throughout the room. Patients can
gather around them and are able to see the
plants, while also receiving the benefits
of their scents. Psychologically, a visual
connection with plants and other elements of
nature has tremendous healing abilities.
Glass doors, which enclose the garden

elements, open for watering and maintenance
of the plants. This also gives the opportunity
for patients to help with the upkeep and
watering of the plants, which provides
another way for patients to interact and hold
some control over their situation.
135
COMPONENTS OF THE VERTICAL
GARDENS
The Vertical Gardens consist of self-
containing glass tubes with several shelves
containing plants. Patients are thus given a
visual connection with the plants and over
time will be able to notice and observe the
plants as they change and start losing leaves
and branches as they die off and re-grow new
Water drains through plant shelves which are
life form in replacement. This growth and life
Tubes collect scent from plants and
disperses throughout honeycomb removable for maintenance cycle provides hope to patients who are in the
ceiling process of growing themselves, mentally and
physically.
The self-containing systems need periodic

Water is pumped up
when needed by plants
watering. Perforated shelves allow excess
water to make its way down the shelves,
feeding each of the different plants. Left
over water is stored in a water reservoir at
Carbon filter draws scent
to patient and then filters the bottom. When the plants need watering,
out scent the water is pumped up through tubes and
Vent intake redirects air from plants to patients sprinkled down from the top (see Ill. 7.23).
Each plant has a unique scent, which is

captured through the vents located on the
inner tube structure. The scent is moved
up through the tube systems and can be
dispersed throughout the honeycomb ceiling
over the patient when desired. The flexibility
of this system allows different patients to
have different scents delivered to them as
Water reservoir they please. Growing lights are also located
on the sides of the glass enclosure to make
Stainless steel for L.E.D. growing lights provide plants with
easy cleaning up for the lack of direct sunlight due to their
required light for growth
interior location.
ILL. 7.23. Axo, Vertical Gardens
136 137
The Vertical Gardens are dispersed throughout honeycomb ceiling to each patient, as desired
the chemotherapy suite, mimicking a forest (see Ill. 7.25). The gardens are self-contained
of trees (see Ill. 7.24). Depending on where systems that allow patients to interact with
Patient patients are seated, they can view vertical them. The patients can touch, move, or water
recliner
chairs
gardens that are both close and far. The plants by opening the glass doors. The glass
gardens are visually stimulating, as well as capsule visually connects the gardens to the
actively working through the scents they give patients, while also enclosing the plants to
off from the variety of plants they contain. avoid dirt or unwanted scents from reaching
These scents are carried throughout the those who may be slightly sensitive.
Vertical gardens
Mobile storage and
privacy screen
Plant scent dispersed

throughout honeycomb Honeycomb ceiling
Private
rooms ceiling
Coloured lights illuminate to

meet patient needs
Water travels down

Optional scent cone to through perforated
help control scent plant shelves
Vertical gardens Vertical gardens Carbon filter draws Water

scent down to patient reservoir
and then filters out
scent
ILL. 7.24. Grand River Chemo Suite, 1:150 ILL. 7.25. Vertical Garden Section, 1:40
138 139
BEFORE AFTER
FIG. 7.1. Grand River Chemo Suite, Existing (2015) ILL. 7.26. Grand River Chemo Suite, Proposed
PROPOSED RETROFIT light and material quality compared to many white-tile, and there is not much to focus a wooden honeycomb ceiling, all of which
The two images above show the contrast older chemotherapy suites, as well as the your view on, except the medical equipment give patients something else to focus on (see
between the existing chemotherapy suite at main part of Grand River Hospital (see Fig. and the patient across from you. Even the Ill. 7.26). This allows the body to relax and
Grand River Hospital and the opportunities 7.1). Despite large windows overlooking a patients located near the window face away move into a healing state, making it easier to
that the vertical gardens offer: a warmer, green space outside and the columns covered from the outdoor view in order to be in recover from harsh treatments and infections,
more inviting space for patients to enter and in wood, the room still feels very much sight of the nurses, should they ever need all the while making the experience more
continue their healing process. The existing like an institutional room in a hospital. The anything. The proposed chemotherapy suite tolerable and peaceful for both patient and
chemotherapy suite was built fairly recently, walls and ceiling are stark white, the lights offers soothing plants, vinyl wood flooring staff.
opening in 2003, and has relatively good are bright, the floor is typical, hospital vinyl (ideal for sanitary reasons in a hospital), and
140 141
DESIGN DEVELOPMENT EVALUATIONS
ILL. 7.27. Chemo Suite Proposal Evaluations

IDEAL DESIGN 1: WILE WALL DESIGN 2: SCENTCUBATORS DESIGN 3: VERTICAL GARDENS
The ideal situation would have the Scent from plants makes its way to patient. Scent and light are encompassing, contained Plants become focus in room, representing
source of a scent well contained and Compartments separate plants. within zone of treatment life, cycles, healing, growing - HOPE
located directly under a patient’s nose.
However for patient comfort and No chemical odors or poisonous inhalation Light and scent well contained Light and scent relatively well
psychological healing, the design must contained
incorporate comfort, flexibility, and Adaptability and ability to choose to open Adaptable to each patient
mindfulness into the design. and close different compartments Adaptable to each patient
The designs reviewed have a variety of Visual connection to plant is beneficial

strengths and limitations as noted here
(see Ill. 7.27). While there is no perfect
design, they each address different Large footprint - could be difficult to install Visual connection to plant is lost Vertical Gardens may make cleaning of
aspects of the patient’s needs in the in existing chemo suites chemo suite slightly more challenging
chemo suite. It is important to bring Patients risk feeling slightly
these topics into the discussion of the Large effective area - could be hard to claustrophobic
value of internal and psychological control scent without affecting surrounding
healing areas
142 143
WHERE CAN ARCHITECTURE OFFER FURTHER HEALING?
HOW DO PEOPLE ENTER THE WHERE DO PEOPLE WAIT? WHERE

PREMISES? CAN PEOPLE GO FOR EMOTIONAL
The first few moments of arrival at the HEALING?
site can drastically affect patients. If There is a lot of waiting between
they are calm upon arrival, chances treatments. Fear and anxiety can easily
are they will better be able to handle build when people feel intimidated and
stress once inside. uncomfortable. Healing spaces should
provide psychologically safe areas to
which patients can occasionally retreat.
TIME
BLOOD
CHECK DRAW MRI DOCTOR
IN WAIT WAIT
WAIT
WAIT
CHEMO
Anxiety Levels Time Spent
Low Anxiety Short

ILL. 7.28. Suggestion of an ideal chemotherapy healing space
High Anxiety Longer
In an ideal situation without limitations of sit for comfort and stimulation. This space
budget or space, Ill. 7.28 suggests what an resembles a living room in a private home. HOW ARE PATIENTS GREETED HOW DO THE TRANSITION SPACES
ideal chemotherapy healing space could look With the home being a big comfort for so BY ARCHITECTURE? SUPPORT PATIENTS?
A hospital is “an institution in which Moving from one suite to another, from
like. It incorporates many elements, lacking many people, this characteristic is extremely
sick or injured persons are given one treatment to another, can be very
in typical chemotherapy suites, which have valuable. The space does not feel like an medical or surgical treatment.”3 stressful as patients try to digest what
turned out to be critical for proper healing: institutional treatment room, which helps Essentially, people visit in order to they just experienced or the news they
natural light, soothing colours, access to the patients take their mind off of their illness and cure an illness and, upon entering the just received, all while anticipating the
outdoors via a private terrace that connects to the negativities that surround it. A calming building, they should feel uplifted and next procedure. Transition spaces such
encouraged to heal. as hallways and rest points, have the
a communal green space, visual connections area that also encourages visitors to come and
opportunity to encourage patients to
to plants and wildlife as well as a living emotionally support the patient will guide take a minute to breath and calm their
indoor green wall, soft materials, privacy the patient to focus on healing and having a thoughts.
from the rest of the hospital, control over the positive mindset. This will help avoid a stress
fireplace and blinds, and plenty of options to reaction and aid the healing process. ILL. 7.29. Where Architecture can offer Healing?
3) “Hospital.” Collins English Dictionary - Complete & Unabridged

10th Edition. HarperCollins Publishers, accessed Jun 1, 2015, http://
dictionary.reference.com/browse/hospital?s=t.
144 145
CRUCIAL MOMENT: ARRIVAL
MOMENT OF ARRIVAL
WHAT DOES THE In addition to the chemotherapy suite, the
KING STREET WEST
PARKING LOT FEEL arrival at the hospital is a significant moment
LIKE? where is it crucial to control stress (see Ill.
P Unless a patient is dropped 7.30). The hospital is a backdrop for many
H off at the front entrance by great joys and far too many heart breaking
a caregiver, the parking lot moments. The arrival establishes the initial
is likely the first space the stress baseline for the patient’s visit.
N patient will enter during a
visit to the hospital. The arrival must be such as to keep patients
1:6000 calm, to help prepare them for the rest of
WHAT DOES THE
the visit. If the mind is able to stay in the
WALK TO THE
moment rather than jumping to the past or
ENTRANCE FEEL
future worries, it will be easier to maintain
LIKE?
control of thoughts, feelings, and sensations.
The walk from the parking
This can lead to inner calmness, acceptance,
lot to the hospital is likely
and openness.4 “In many cases, one feeling
to stir up many emotions of
threatened may actually have more to do with
fear, anxiety, and worry, as
one’s state of mind on the situation more than
patients try to best prepare
the triggering of the event itself.”5
for the day ahead, knowing
“
it may be full of pain and
disappointing news.
At the moment most hospital
WHAT DOES THE environments say to the patient, in effect:
MOMENT OF ‘How you feel is unimportant. You are
ENTRANCE FEEL not of value. Fit in with us, not us with
LIKE? you’. With very little effort and money
The moment of entrance this could be changed to something like:
„
sets the tone for patients. ‘Welcome! And don’t worry we are here
The entrance has potential to reassure you, and your treatment will be
to make them feel welcome good and helpful to you’. Why shouldn’t
and safe, and trusting right the patient look forward to a day at the
from the moment of arrival. hospital?6
- Maggie Jencks
ILL. 7.30. Detailed Site Plan, Grand River Hospital, 1:2000 illustrating important
phases of the entrance to the hospital
4) Kabat-Zinn, Jon. 1990. “On Healing.” Chap. 13, In Full

5) Ibid.
6) Jencks, Maggie Keswick. 1995. A View from the Front Line:
Marcia Blakenham. 21-22.
146 147
FIG. 7.2. Existing Parking Garage (2015) FIG. 7.3. Existing View at Front Entrance (2015)
ILL. 7.31. Proposed Drop-off Area at the Front Entrance of the Cancer Centre ILL. 7.32. Proposed Drop-off Area at the Front Entrance of the Cancer Centre
The current parking lot is very dark and hard very welcoming and allows people to be wet welcoming you from the instant you leave entering the building and allows for relaxed
to maneuver around with steep stairs and or cold if the weather is unpleasant (see Fig. the comfort of your vehicle (see Ill. 7.31 waiting, while loved ones park the car.
tight parking spaces (see Fig. 7.2). It also 7.3). Imagine driving up into this space: the & 7.32). Surrounded by plants and natural
requires a walk outside to reach the hospital moment you exit the car you are already being wood arches, the proposed entrance offers a
entrance. The existing drop-off area isn’t embraced by the building. The architecture is mini-oasis to calm nervous thoughts before
148 149
GRAND RIVER REGIONAL CANCER CENTRE ANALYSIS
Below is a visual list of spaces that are

important to consider when re-thinking where
architecture can offer healing.
FIG. 7.7. Entrance
FIG. 7.4. Lobby
FIG. 7.8. Lobby
ILL. 7.33. Ground Floor Plan, Grand River Hospital, 1:500
Chemotherapy Suite
FIG. 7.5. Chemotherapy Waiting
FIG. 7.9. Doctor Visit Waiting Area
FIG. 7.6. Examination Room Corridor

ILL. 7.34. Upper Floor Plan, Grand River Hospital, 1:500
150 151
Comfortable: 15-25*C
4.5 months of
“ideal” outdoor temperature
ILL. 7.36. The daily average low (blue) and high (red) temperatures with percentile
bands (inner band from 25th to 75th percentile, outer band from 10th to 90th
percentile) of Toronto, Ontario.
The graph above shows the daily average partly conditioned exterior spaces in order
temperatures for Toronto (approximately to maximize their usage. Cancer patients
115km east of Grand River Hospital in are often very sensitive to their climate. The
ILL. 7.35. Ground Floor Plan with proposed Entrance Dome, 1:500 Kitchener) and indicates the 4.5 months per proposed entrance features engineered wood
year when the outdoor temperature is “ideal” arches enclosed with glazing and offers
for being out-of-doors: approximately 15- the opportunity to run heating or cooling
25*C (see Ill. 7.36). With less than half of the throughout the space. The glazing provides
year having ideal temperatures, excluding a dry place in the rain and can be tinted for
the days with rain or high winds which can those days where the sun is very bright.
be uncomfortable, it is beneficial to have
152 153
Part VII reviewed the goals of the design
development which were set up to address the
challenges associated with cancer treatment.
These goals include adaptability, flexibility
and localization. The Wile Wall was an initial
attempt to incorporate plants and colour into
the chemo suite. Its large size and inability
to control the scents led to the Scentcubator
5000 which improved in these areas, yet
lacked the visual connection to the foliage
which has been proven to be extremely
valuable in numerous studies. Finally the
Vertical Gardens iteration was able to take
advantage of the strengths of the first two
designs, presenting the most refined project.
Each design can be studied for its particular
scale of architecture and unique strengths.
155
CONCLUSION
“In general hospitals are not patient- experts are Roger Ulrich, who is a pioneer and connection to nature. Although these Other positive examples that influenced the
friendly. Illness shrinks the patient’s in the studies of Evidence Based Design spatial considerations in design cannot cure design of the three projects mentioned include
confidence, and arriving for the first time medicine and Maggie Jencks, who battled an illness, they are vital assets in a healing the Humber River Hospital and the Dyson
at a huge NHS [National Health Services] with breast cancer until she passed away environment to place the body in a state Centre where people are given control (or
hospital is often a time of unnecessary from the disease in 1995. Jencks offers a where it has the best opportunity for healing perceived control) over their environments.
anxiety. Simply finding your way around very real and humble account of her hospital and recovering. This kind of control also proved extremely
is exhausting... Overhead (sometimes even experiences in A View From The Frontline, successful in the Senior’s Residence by
neon) lighting, interior spaces with no as she describes the range of emotions she In an attempt to explore the ability of Peter Zumthor, providing residents with
views out and miserable seating against the felt and the difficulties she faced while trying environments to augment healing, three dignity through detailing, despite their loss
walls all contribute to extreme mental and to cope in such an emotionally unforgiving design developments were proposed. The of independence.
physical enervation. Patients who arrive place. Wile Wall took an initial attempt to explore
relatively hopeful soon start to wilt.”1 the effects of scent and coloured light on For the future, many of the challenges
After Maggie Jencks passed away, inspired patients and how these could be incorporated with hospital design include the very
Healing goes far beyond treating physical by her struggles, her husband Charles Jencks into a building. The Scentcubator 5000 used strict regulations to meet health standards,
symptoms, yet hospitals have gradually began the design of Maggie’s Centres. Unique the concept of the Wile Wall and translated the constant changing of knowledge and
moved away from a holistic healing focus in for its time, this series of retreat centres offers it into a furniture scaled object to examine technologies, which inform the use of
the past 80 years with the rise of technology. an extraordinary perspective on the power of the potential of completely encompassing a spaces and ways of operating, and the high
More technological advances do not healing spaces and how they are able to help patient in the effects of scent and light. The costs associated with hospital construction
necessarily equate to better care, which is people control their stress and anxiety when Vertical Garden was able to take the strengths and renovation. This thesis focused on the
what several Evidence Based Design studies faced with unbearable emotional and physical of both the Wile Wall and the Scentcubator exploration of potential designs that could
are finding. pain from cancer. These retreat centres do and develop an intervention at the room scale stimulate the senses in order to activate brain
not have any secret ingredient; they simply to address patients and nurses in the design. pharmaceuticals that would naturally help to
As discussed in this thesis, stress is one of provide a quiet space for people to cry if It focused on a communal usage, opening reduce stress and aid healing. With over 100
the most common and most detrimental they need to, take a walk in the garden, or patients up to the rest of the room guided hospitals in Ontario that offer chemotherapy,
factors working against a patient’s recovery. sit around a kitchen table with others who by the research done on how beneficial peer this thesis explored designs that could
However, many hospitals breed stress in the similarly understand the journey they are support is for healing. The gardens encourage certainly be implemented in many of them.
way patients enter the spaces and are restricted going through and can provide support. patients to feel part of a larger group and
to little or no connection with different There are many different types of cancer and offer an opportunity to focus on living plants There is no one perfect design, but this thesis
colours, smells, light, or natural elements. many more kinds of emotional journeys that that represent hope, growth, and renewal. attempts to continue the ever-important
As many experts have argued, when people people walk. No one journey is the same, but This design attempts to humanize the chemo conversation around the value of designing
feel happier and more comfortable, their patients have common fears and anxieties suite by making patients feel like more than for the person, not just the patient.
body responds in a positive way, which will that can be addressed through calming numbers in a system, and sites of a disease.
boost healing by strengthening their immune environments that promote stress reduction. What they think and how they feel is just as
system. This all starts with the environment These environments have a number of important as the treatment they receive.
to which a patient is subjected. Among these elements in common: light, colour, privacy,
1) Jencks, Maggie Keswick. 1995. A View from the Front Line:

Marcia Blakenham. 21.
156 157
REFERENCES
“Commonweal Retreat Center.” Commonweal., last modified Jun 1 2015, accessed Feb 5, “Radiation Therapy for Cancer.” National Cancer Institute., last modified June 30, 2010,
2015, http://www.commonweal.org/. accessed January 9, 2015, 2015,
http://www.cancer.gov/about-cancer/treatment/types/radiation-therapy/radiation-fact-sheet.
“Architecture.” Thorncrown Chapel., last modified 2015, accessed Jun 4, 2015, www.
thorncrown.com/architecture.html. “Regional Cancer Programs.” Cancer Care Ontario., last modified Nov 3 2009, accessed Dec
10, 2014, www.cancercare.on.ca/cms/one.aspx?portalId=1377&pageId=8958.
“Rehab Basel.” MIMOA; Mi Modern Architecture., last modified 2015, accessed Jan 2, , www.
mimoa.eu/projects/Switzerland/Basel/REHAB%20Basel. “Cancer Program.” Grand River Hospital., accessed Mar 3, 2015,
http://www.grhosp.on.ca/CANCERPROGRAM.
“Neupogen.”, last modified 2014, accessed Nov 1, 2014, http://www.neupogen.com/.
“What is the Vagus Nerve?” wiseGEEK, accessed Oct 15, 2014,
“The Nature of Things with David Suzuki, Dreams of the Future, Science of Natural Therapy.” http://www.wisegeek.org/what-is-the-vagus-nerve.htm#didyouknowout.
CBC. CBC, last modified 2014, accessed Oct 10, 2014.
“Peripheral Nerves.” API Study Guide, accessed Oct 15, 2014,
“Hippocratic Oath, Modern Version.” John Hopkins, Sheridan Libraries., last modified 2014, http://legacy.owensboro.kctcs.edu/gcaplan/anat/notes/api%20notes%20m%20%20
accessed Dec 10, 2014,http://guides.library.jhu.edu/content.php?pid=23699&sid=190964. peripheral%20nerves.htm.
“Cancer Statistics.” Waterloo Wellington Regional Cancer Program., last modified 2014, “What is Holistic Medicine?” WebMD., accessed Dec 10, 2014,
accessed Apr 4, 2015, www.ww-rcp.on.ca/cancerstatistics/. http://www.webmd.com/balance/guide/what-is-holistic-medicine.
“Pituitary Gland.” Society for Endocrinology., last modified 2013, accessed Sept 17, 2014, “Rain Room.” RANDOM., accessed Dec 30, 2014,
http://www.yourhormones.info/glands/pituitary_gland.aspx. http://random-international.com/work/rainroom/.
“Definition of Placebo Effect.” MedicineNet Inc., last modified 2012, accessed Oct 14, 2014, “The NASA Sleep Promoting Light Bulb.” Hammacher Schlemmer., accessed Jan 19, 2015,
http://www.medicinenet.com/script/main/art.asp?articlekey=31481. http://www.hammacher.com/Product/Default.aspx?sku=86494.
“What are Opioids?” National Institute on Drug Abuse., last modified 2011, accessed Oct 13, “Hospital.” Collins English Dictionary - Complete & Unabridged 10th Edition. HarperCollins
2014, Publishers, accessed Jun 1, 2015,http://dictionary.reference.com/browse/hospital?s=t.
http://www.drugabuse.gov/publications/research-reports/prescription-drugs/opioids/what-are-
opioids. “Split Time Café.” Philippe Rahm Architectes., accessed Oct 1, 2014,
http://www.philipperahm.com/data/projects/splittimescafe/index.html.
“Mind is a Frequent, but Not Happy Wanderer: People Spend nearly Half their Waking Hours
Thinking about what Isn’t Going on Around them.” 2010. “Hormonorium.” Philippe Rahm Architectes., accessed Sept 27, 2014,
http://www.philipperahm.com/data/projects/hormonorium/index.html.
158 159
“Diurnism.” Philippe Rahm Architectes., accessed Oct 1, 2014, Popular Science., last modified Nov 29 2012, accessed Oct 25, 2014,
http://www.philipperahm.com/data/projects/diurnisme/index.html. http://www.popsci.com/technology/article/2012-11/fight-winter-doldrums-swedish-electrical-
company-showers-bus-stations-uv-light.
“Center for Cancer and Health - Danish Architecture Centre.” Danish Architecture Centre.,
accessed Oct 2, 2014, Pregnant in America. YouTube. Directed by Steve Buonaugurio and Mandy Buonaugurio.
http://www.dac.dk/en/dac-life/copenhagen-x-gallery/cases/center-of-cancer-and-health/. 2008.
“Grandnm”. “Healing Architecture.” Scribd., last modified Apr 8, 2014, accessed Sept 24, Burpee, Heather. 2008. “History of Healthcare Architecture.” 2.
2014, http://www.scribd.com/doc/216951537/Healing-Architecture.
Chiasson, AnnMarie, Ann Linda Baldwin, Carrol Mclaughlin, Paula Cook, and Gulshan Sethi.
Allred, Kelly D., Jacqueline F. Byres, and Mary Lou Sole. 2010. “The Effect of Music on 2013. “The Effect of Live Spontaneous Harp Music on Patients in the Intensive Care Unit.”
Postoperative Pain and Anxiety.” 11 (1): 15-25. doi:2010. 2013. doi:Nov 12, 2013.
Report about Dark Restaurant NOCTI VAGUS (Berlin). YouTube. Directed by YouTube User Christie, Nathan. “Touring the Huge New Humber River Hospital, Part Two.” Urban Toronto.,
anike1990. 2012. last modified Apr 1 2015, accessed May 5, 2015,
urbantoronto.ca/news/2015/04/touring-huge-new-humber-river-hospital-part-two.
Archer, S., S. Bucton, and D. Sheffield. 2014. “The Effect of Creative Psychological
Interventions on Psychological Outcomes for Adult Cancer Patients: A Systematic Review of De Botton, Alain. 2013. “Art for Life’s Sake.” Wall Street Journal, 84.
Randomised Controlled Trials.” Psycho-Oncology. doi:2014.
Evans, Dr M. “Cancer Related Fatigue.” Sunnybrook., accessed Nov 1, 2014,
Awofeso, Niyi. “Re-Defining ‘Health’.” World Health Organization. WHO, last modified 2005, http://health.sunnybrook.ca/cancer-fatigue-content/video/.
accessed Jun 5, 2015, http://www.who.int/bulletin/bulletin_board/83/ustun11051/en/.
Hamilton, Kirk. 2006. “Evidence Based Design and the Art of Healing.” In The Architecture of
Bateson, Lynne. “Smells to make You Well.” Daily Express Health. Daily Express Health RSS, Hospitals, 271-280: NAi Publishers.
last modified Dec 4 2012, accessed Sept 18, 2014,
http://www.express.co.uk/life-style/health/362320/Smells-to-make-you-well. Hamilton, Kirk. 2010. “Role of Design in Creating Therapeutic Environments.” Chap. 10.4, In
Design for Critical Care, 251. Burlington, MA: Elsevier Ltd.
Bowen, R. “Adrenocorticotropic Hormone (ACTH, Corticotropin).”, last modified 1998,
accessed Oct 12, 2014, Hathom, Kathy and Nanda, Upali. “Guide to Evidence-Based Art.” The Center for Health
http://arbl.cvmbs.colostate.edu/hbooks/pathphys/endocrine/hypopit/acth.html. Design., last modified 2008, accessed Sept 19, 2014,
https://www.healthdesign.org/chd/research/guide-evidence-based-art.
Boyle, Rebecca. “To Fight Winter Blahs, Sweden Offers Light Therapy at the Bus Stop.”
Hazlewood, Kelsey. “Light, Color, Sound.” College of Design and Walter Cronkite School of
Journalism and Mass Communication, Arizona State University, last modified 2008, accessed
Oct 12, 2014, http://cronkitezine.asu.edu/healing/environments/banner.html.
160 161
Holtzman, Liliana. “Healing Spaces.” Gracious Living, Day by Day., last modified Jan 14 Maddox, Lucy. “Can the Design of Hospitals Help Patients Recover Faster?” Gizmodo., last
2013, accessed May 4, 2015, http://graciouslivingdaybyday.com/2013/01/14/calm-spaces/. modified Nov 25 2014, accessed Dec 9, 2014,
http://gizmodo.com/can-the-design-of-hospitals-help-patients-recover-faste-1663083331.
Hsu, Zoe Y., D. S. Moskowitz, and Simon Young N. 2013. “The Influence of Light
Administration on Interpersonal Behavior and Affect in People with Mild to Moderate Malkin, Jain. 1992. “Creating a Healing Environment.” In Hospital Interior Architecture, 13-
Seasonality.” Progress in Neuro-Psychopharmacology & Biological Psychiatry: 92-101. 17.
Jacobs, Keither W., and James F. Suess. “Effects of Four Psychological Primary Colors on Mayo Clinic Staff. “Chronic Stress Puts Your Health at Risk.”, accessed Oct 12, 2014,
Anxiety State.” Ammons Scientific 41: Setp 15, 2014-207-210. doi:10.2466/pms.1975.41.1.207. http://www.mayoclinic.org/healthy-living/stress-management/in-depth/stress/art-20046037.
Jencks, Maggie Keswick. 1995. A View from the Front Line: Marcia Blakenham. McKahan, Donald. “Healing by Design.” Sandow Media LLC, last modified 1993, accessed
Oct 14, 2014, http://www.interiordesign.net/.
Jynto. “Dopamine Molecule”.
Mills, Ben. “Morphine Molecule”.
Kabat-Zinn, Jon. 1990. “On Healing.” Chap. 13, In Full Catastrophe Living, 179. New York,
NY: Dell Publishing. Moyers, Bill. 1993. “Wounded Healers.” Parabola, the Magazine of Myth and Tradition, 21.
Kemp, Stephen and Stoppler, Melissa C. “Anatomy of the Endocrine System.”, accessed Oct National Institute of Allergy and Infectious Diseases. “Understanding the Immune System.”,
15, 2014, last modified 2014, accessed Oct 18, 2014,
http://www.emedicinehealth.com/anatomy_of_the_endocrine_system/article_em.htm. http://www.niaid.nih.gov/topics/immunesystem/Pages/default.aspx.
Killing, Alison. “There’s a Better Way to Die, and Architecture can Help.” TED. TEDGlobal Ong, Iliyas. “Healing Spaces.” Going Places., last modified 2014, accessed May 2, 2015,
2014, last modified Oct 2014, accessed Dec 5, 2014, http://www.goingplacessingapore.sg/design/2014/HealingSpaces.aspx.
https://www.ted.com/talks/alison_killing_there_s_a_better_way_to_die_and_architecture_can_
help?language=en. Picard, Andre. “A Challenge for New Doctors: Focus on the Patient, Not just the Symptoms.”
The Globe and Mail. The Globe and Mail, last modified Jun 9 2015, accessed Jun 10, 2015,
Koga, Kazuko and Yutaka Iwasaki. 3013. “Psychological and Physiological Effect in Humans http://www.theglobeandmail.com/life/health-and-fitness/health/a-challenge-for-new-doctors-
of Touching Plant Foliage - using Semantic Differential Method and Cerebral Activity as focus-on-the-patient-not-just-the-symptoms/article24859080/.
Indicators.” Journal of Physiological Anthropology.
Ramsay, Adam. “Health Benefits of Music.” Netdoctor., last modified Nov 29, 2011, accessed
Komiske, Bruce King. 2013. In Designing the World’s Best Children’s Hospitals 3. 3rd ed., Sept 20, 2014,
187: Images Publishing Dist Ac. http://www.netdoctor.co.uk/healthy-living/wellbeing/health-benefits-of-music.htm.
Levitt, Andrew. 2015. The Inner Studio. A Designers Guide to the Resources of the Psyche. Remy, Ruane. 2014. “Southdown has Right-Sized.” Catholic Register, Sept 14, 2014, 13.
Vol. Arch 641 Lecture.
162 163
Riversong, Robert. “Death by Medicine.” Turning the Tide., accessed Nov 1, 2014, Wagenaar, Cor. 2005. “Healing by Architecture.” In The Architecture of Hospitals, 254: NAI
http://riversong.wordpress.com/death-by-medicine/. Publishers.
Rose, Steve. “Maggie’s Centres: Can Architecture Cure Cancer?” The Guardian, last modified Wat, Timothy. 2014. “Moments of Spiritual Engagement in Architecture.” Masters of
May 6 2010, accessed Jun 20, 2015, Architecture, University of Waterloo.
http://www.theguardian.com/artanddesign/2010/may/06/maggies-centres-cancer-architecture.
Rosenfield, Karissa. “Can Well-Designed Hospitals Shorten Recovery Times?” Arch Daily.,
last modified Nov 25 2014, accessed Dec 29, 2014,
http://www.archdaily.com/572185/can-well-designed-hospitals-shorten-recovery-times/.
Sbrools. “Melatonin Molecule”.
Seiler, Bill. “Joyful Music may Promote Heart Health.” UMM. University of Maryland
Medical Center, last modified Nov 11, 2008, accessed Sept 19, 2014,
http://umm.edu/news-and-events/news-releases/2008/joyful-music-may-promote-heart-health.
Shane, Simone. “The Calming Effect of Music.” Serendip Studio. Serendip Studio, last
modified Oct 5, 2008, accessed Sept 10, 2014,
http://serendip.brynmawr.edu/exchange/node/2486.
Sternberg, Esther and Tippett, Krista. “Esther Sternberg - the Science of Healing Places.” On
Being, last modified 2013, accessed Sept 17, 2014,
http://www.onbeing.org/program/the-science-of-healing-places/4856/audio?embed=1.
Stoppler, Melissa C. and Shiel, William C. “Endorphins: Natural Pain and Stress Fighters.”
MedicineNet.com., accessed Oct 10, 2014,
http://www.medicinenet.com/script/main/art.asp?articlekey=55001.
Swan, Michael. 2015. “Bringing the Human Back into Hospital Design.” Catholic Register, 14
June, 16.
Ulrich, Roger S. 1984. “View through a Window may Influence Recovery from Surgery.”
Science 224 (4647).
164 165
Trying to make cancer treatment a little less awful

Healing

Uploaded by

Copyright:

Available Formats

Healing

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Healing

Uploaded by

Copyright:

Available Formats

Healing through Architecture

Jennifer Lynda Beggs

Waterloo, Ontario, Canada, 2015

I understand that my thesis may be made electronically available to the public.

1) Sternberg, Esther and Tippett, Krista. “Esther Sternberg - the

PART I p. 30 Fig. 3.2 Commonweal Retreat Center, Kohler House

PART II p. 26 Ill. 3.4 Pituitary Gland in Brain

p. 24 Ill. 3.1 Holistic Healing QWerk. 2008. Codedine molecule,

PART V p. 87 Ill. 5.8 14-DAY TREATMENT CYCLE

p. 142-3 Ill. 7.27 Chemo Suite Proposal Evaluations

p. 144 Ill. 7.28 Suggestion of an ideal chemotherapy healing space

p. 145 Ill. 7.29 Where Architecture can oﬀer Healing?

Spaces are good mediums for aﬀecting

The human body has an incredible ability to

2) Sternberg, Esther**, and Tippett, Krista. Esther Sternberg. The

7) Kabat¬Zinn, Jon. 1990. “On Healing.” Chap. 13, In Full

In order to realistically move towards fully

4) Ibid. Page 267.

DEFINITION OF HEALTH “PREGNANT IN AMERICA”

15) Awofeso, Niyi. “ReDeﬁning ‘Health’.” World Health

THEORY OF SUPPORTIVE DESIGN VIEW THROUGH A WINDOW MAY VIEWS OF NATURE

23) Maddox, Lucy. “Can the Design of Hospitals Help Patients

Part III examines the diﬀerent brain

Numerous studies show much evidence of the

Active strategies introduce psychological

2) “What is Holistic Medicine?” WebMD., accessed Dec 10, 2014,

Traditional drugs often have

ILL. 3.6. Traditional Drugs vs. Brain Pharmaceuticals

7) Stoppler, Melissa C. and Shiel, William C. “Endorphins: Natural

9) “Commonweal Retreat Center.” Commonweal., last modiﬁed Jun

20) Killing, Alison. “There’s a Better Way to Die, and Architecture

The following Four Senses Mindmap explores

beta brain waves which

eﬀects, slows reactions, HEAR

Peppermint (and cinnamon) Slower rhythms More strong pain meds

a calming eﬀect on mice31

75% of claustrophobic “Smells Lifeways Centre vs.

aggressive, had fewer ﬁghts, Time Cafe

Scent reduces systolic

trees, herbs people experience an hall, London

stress response by kicking in ancient times to plant. Metal Stimulus

Many of the projects and studies in the

Melatonin release blocked

Furniture is tall, encouraging Furniture is soft, closer to a lounge White furniture

37) “Split Time Café.” Philippe Rahm Architectes., accessed Oct

(4) WHITE BENCHES (528) INTENSE FLUORESCENT WHITE LIGHTS

pinean gland in the brain resulting in decreased

38) “Hormonorium.” Philippe Rahm Architectes., accessed Sept 27,

ORANGE AND YELLOW

Reversed “nocturnes for the

39) “Diurnism.” Philippe Rahm Architectes., accessed Oct 1, 2014,

47) Maddox, Lucy. “Can the Design of Hospitals Help Patients

Interior material palette

White walls Wood ﬂoor Windows

Exterior material palette

51) “Center for Cancer and Health Danish Architecture Centre.”

54) “The Nature of Things with David Suzuki, Dreams of the

The research presents the major inﬂuences

As understood in Part III, while taking

1) Burpee, Heather. 2008. “History of Healthcare Architecture.” 1. 3) Ibid.