Designing Penfield: Inside the Montreal Neurological Institute.

Neurosurgeon Wilder Penfield (1891-1976) envisioned hospital architecture as a powerful medical tool. Focusing on two key interiors in the 1934 Montreal Neurological Institute (MNI)-the operating room and the foyer-this article engages newly accessible textual and material evidence to show Penfield's intense involvement in the design of the building. A unique, tri-level surgical room, with a sophisticated setup for photography, made the MNI's surgery interactive. The OR is discussed with regard to the relationship of doctors and architects and Penfield's penchant for architectural travel. Subsequently, we visit the foyer as a spatial counterpoint to the operating room. Its design enabled a particular, Penfield-inspired view of the brain and recounted neurological history in the language of Art Deco design. An emphasis on axial movement pushed visitors to "consume" a work of sculpture, meticulously copied from another in Paris. The architecture of the MNI thus monumentalized Penfield's accomplishments, by his own design.

19th-century thermosiphon ventilation and its potential for heat recovery in buildings today.

A forgotten thermosiphon scheme is found in Montreal's former Royal Victoria Hospital and traced back to the original Center Block of Canada's Parliament Hill. This discovery inspires an investigation into the fluid mechanics of heat recovery with buoyancy ventilation, where interior spaces are arranged in an open thermal loop with heat exchange through partition walls. Flow visualizations with physical models are used to corroborate the archival evidence and show how the historical scheme worked. The scheme is then generalized, defining a criterion for steady unidirectional flow (λ>1) and a heat recovery limit when room temperatures upstream and downstream reach equilibrium (ε≤50%). This mathematical model is validated experimentally, demonstrating steady flow (λ∼2.21) close to the efficiency limit (ε∼0.40) with a balanced thermal design (NTU∼1). Further analysis shows significant heating savings are possible in mildly cold seasons compared to natural displacement (74%) and natural mixing (60%) ventilation.

"Not a shack in the woods": architecture for tuberculosis in Muskoka and Toronto.

This paper explores architecture as a primary source in the history of tuberculosis. In comparing five Ontario sanatoria built between 1897 and 1923, we identify a range of types and a growing resemblance of ex-urban TB sanatoria to urban hospitals. Existing literature on Canadian TB hospital architecture suggests the endurance of picturesque architecture, but the cottage plan was only one of the types deemed appropriate for consumptives in the early 20th century, even in Muskoka. Furthermore we argue that urban and ex-urban TB ideologies actually coalesce about 1923, best illustrated in the boldly modern architecture of Muskoka's new Gage pavilion.

Designing for "the little convalescents": children's hospitals in Toronto and Montreal, 1875-2006.

This paper explores more than a century of changing ideas about the health of Canadian children through the architecture of pediatric hospitals in Montreal and Toronto. As a unique source in the history of medicine, hospital architecture reveals three distinct phases in the construction of children as patients. Early 20th-century children's hospitals remained bastions of older spatial attitudes towards health. The postwar hospital was self-consciously modern, with an arrangement more scientific and institutional than its predecessor. Through reference to other typologies, the postmodern hospital marks a curious return to the earlier attitude that children's health is a family affair. Is the hospital a home for children or an institution for science?

Kids in the atrium: comparing architectural intentions and children's experiences in a pediatric hospital lobby.

The study reported here adopts an interdisciplinary focus to elicit children's views about hospital environments. Based at the Hospital for Sick Children (SickKids), Toronto, the research explores the ways in which designers and patients understand and use the eight-storey lobby, The Atrium, a monumental addition constructed in 1993. It is a public place that never closes; hundreds of children pass through the namesake atrium every day. Combining methodological approaches from architectural history and health sociology, the intentions and uses of central features of the hospital atrium are examined. Data were collected from observations, focused interviews, and textual and visual documents. We locate the contemporary atrium in a historical context of building typologies rarely connected to hospital design, such as shopping malls, hotels and airports. We link the design of these multi-storey, glass-roofed spaces to other urban experiences especially consumption as normalizing forces in the everyday lives of Canadian children. Seeking to uncover children's self-identified, self-articulated place within contemporary pediatric hospitals, we assess how the atrium--by providing important, but difficult-to-measure functions such as comfort, socialization, interface, wayfinding, contact with nature and diurnal rhythms, and respite from adjacent medicalized spaces--contributes to the well-being of young patients. We used theoretical underpinnings from architecture and humanistic geography, and participatory methods advocated by child researchers and theorists. Our findings begin to address the significant gap in understanding about the relationship between the perceptions of children and the settings where their healthcare occurs. The study also underlines children's potential to serve as agents of architectural knowledge, reporting on and recording their observations of hospital architecture with remarkable sophistication.

Architecture, religion, and tuberculosis in Sainte-Agathe-des-Monts, Quebec.

This paper explores the architecture of the Mount Sinai Sanatorium in Sainte-Agathe-des-Monts (Qc) to disentangle the role of religion in the treatment of tuberculosis. In particular, we analyze the design of Mount Sinai, the jewel in the crown of Jewish philanthropy in Montreal, in relation to that of the nearby Laurentian Sanatorium. While Mount Sinai offered free treatment to the poor in a stunning, Art Deco building of 1930, the Protestant hospital had by then served paying patients for more than two decades in a purposefully home-like, Tudor-revival setting. Using architectural historian Bernard Herman's concept of embedded landscapes, we show how the two hospitals differed in terms of their relationship to site, access, and, most importantly, to city, knowledge, and community. Architects Scopes & Feustmann, who designed the Laurentian hospital, operated an office at Saranac Lake, New York, America's premier destination for consumptives. The qualifications of Mount Sinai architects Spence & Goodman, however, derived from their experience with Jewish institutions in Montreal. Following Herman's approach to architecture through movement and context, how did notions of medical therapy and Judaism intersect in the plans of Mount Sinai?

Tower of power: the Drummond Medical Building and the interwar centralization of medical practice.

This paper focuses on Montreal's Drummond Medical Building (1929), designed by the well-known architectural firm of Nobbs & Hyde, as a case study of the new typology that emerged in urban Canada in the 1920s: a modern, purpose-built high-rise for healthcare professionals, with elevators, telephones, indoor parking, and retail shops, located in an upscale commercial district. What role did medical high-rises play in the practice of modern medicine? We speculate that these clinics marked the end of the house-office era across Canada, centralizing the practice of healthcare professionals. This CIHR-funded project illustrates complex social and physical networks among architects and doctors, drawing attention to the importance of studying architecture as a technology in the history of modern medicine.