About a month from now a new inpatient facility will open at Hadassah University Hospital in Ein Karem, Jerusalem, doubling the hospital's size. The Sarah Wetsman Davidson Hospital Tower is a huge, 19-story building with an area of 90,000 square meters (equivalent to four average Israeli shopping malls ).
The building was planned jointly by the Texas-based American firm HKS, which specializes in planning hospitals around the world, and the Jerusalem-based Spector-Amisar Architects, which has been overseeing the Hadassah master plan in recent years. The new building contains 500 inpatient beds and 20 operating rooms and, at the foot of the tower, a new entrance to the hospital and traffic system have been built, which will (eventually ) include a terminus for Jerusalem's light-rail system.
"Twenty-five thousand people come here every day - it's like the dimensions of a city," explains architect Arthur Spector. "Hospitals are becoming more like hotels nowadays. They are aiming to treat patients in the best possible way. We have tried to rearrange the campus around the main entrance, which is full of life and greenery and people, and to create a building that will greet you in a very positive way."
The Ein Karem site was established in 1961 after the hospital that Hadassah, the Women's Zionist Organization of America, built on Mount Scopus was cut off from Israeli Jerusalem in the War of Independence and became an enclave inside Jordanian territory. It was built on a hill near the Ein Karem neighborhood, in consultation with Prime Minister David Ben-Gurion.
The hospital was planned by architect Joseph Neufeld (1899-1980 ), one of the pioneers of the International Style in the Land of Israel. Neufeld had prior experience in planning buildings for the health system. In 1935 he designed the Assouta Medical Center in Tel Aviv's old north and, two years later, a health maintenance organization center on Beilinson Street in Tel Aviv, which served as administrative HMO headquarters (and now houses the Kabbalah Center ). Both Assouta and the HMO center building are on the Tel Aviv municipality's preservation list.
At Hadassah it is possible to see Neufeld's effort to free himself from the vocabulary of Tel Aviv's white architecture and his search for a modern language suited to the hospital's natural surroundings. He used red bricks in order to make the building seem to grow out of the mountainous terrain. The bricks were laid as a filling between a skeleton of pillars and concrete walls. The well-known American architectural photographer Julius Shulman immortalized the hospital's construction process and published the photographs in professional magazines in the United States.
Over the years Hadassah's Ein Karem site expanded and developed, and today it consists of a total of 22 buildings, some of which blend well with Neufeld's original building and others of which do it an injustice. The public became closely acquainted with the architecture from news reports broadcast from there during the period of terror attacks at the beginning of the millennium and after former Prime Minister Ariel Sharon's stroke.
Prior to the expansion project the hospital had about 700 beds, some of them in outdated departments that had been renovated in patches. In the near future the veteran building will be converted into a large outpatient wing and research laboratories.
'Get used to it'
In contrast to Neufeld's pragmatic approach, the new inpatient tower has no connection to the scale or delicate lines of the natural surroundings. Though it rises "only" to 14 stories (another five are hidden underground ), it brutally changes the West Jerusalem horizon. Spector tried to break up the huge mass of the building by means of some cracks and angles in the structure, but without much success. The pale Jerusalem stone affixed to it only makes its foreignness more obvious. It is with reason that, prior to the tower's construction, there were unpleasant discussions between the hospital and residents of the area.
Spector explains that current hospital technology requires very dense and vertical construction. "An inpatient room cannot be more than 50 meters from the operating rooms for trauma, and the moment you pile more and more functions onto the building it starts to rise high," he says.
The tower was preceded by a number of low-rise planning alternatives across a larger area, which did not answer the hospital's needs. "All the hospitals in the world today are constructing tall buildings, even in places like Africa and India where there isn't any problem of land," adds Spector. "This isn't a romantic building with a red roof. This is a new scale in the area and the inhabitants will have to get used to it."
At the foot of the building an entry pavilion with a glass roof will funnel all the traffic entering the hospital - patients and visitors who arrive in cars, bus passengers and future passengers of the light-rail line that will connect to the hospital in about five years, if all goes to plan. From here, it will be possible to enter the new inpatient tower and the children's hospital or to continue further into the site. On the other side of the road is a large mall through which most visitors currently access the hospital ("In the future people won't be coming in via the carton of cottage cheese," comments Spector ), and a parking lot of 1,000 spaces hidden in a fold of the land.
In contrast to the tower's outward appearance, the planners have succeeded in creating a pleasant atmosphere inside the departments and corridors. Alongside the new building are four "healing" gardens, planned in collaboration with the Shlomo Aronson firm of landscape architects, with green vegetation and large trees. These gardens afford patients an open area, protected from the weather, for relaxation or meeting with visitors. They are based on biophilic design principles, according to which nature and vegetation have a positive effect on human health.
The main innovation at the hospital is in the patients' rooms, which afford a great deal of privacy to the two patients in each room. At the outset only private rooms were planned at Hadassah, but public opinion surveys the hospital conducted found that Israelis prefer not to be alone at night, "even if their roommate is a complete stranger," according to Hadassah spokesman, Ron Kromer.
Each room is arranged in an angular way that creates two separate spaces. The wooden furniture and synthetic parquet floor together afford a warmth untypical of hospitals. Alongside each bed is a sofa on which a relative can sleep at night. At one point the hospital considered putting small refrigerators in each room but the idea was scuttled for reasons of hygiene.
Spector, who is now designing hospitals in India and Latvia, relates that local culture has considerable influence on hospital planning. "In India, for example, they plan an operating room next to every delivery room because there are many caesarean births. Every mother-to-be wants to choose exactly the hour at which she will give birth because they believe this affects the child's future. In Europe, operating rooms are not next to delivery rooms. The doctors don't allow anyone to get close and they phone the family after the procedure to report what happened."
According to Kromer, in the new Ein Karem building there is comprehensive consideration of Israeli culture. "When you get right down to it, Israelis want to be visited, with the entire tribe, and to be accompanied during the whole hospitalization," he notes. "We believe this can contribute to the recovery process."