ARCHITECTURAL CRITICISM MEETS BUILDING EVALUATION IN JAPAN
Introduction
Hospital buildings have not received a great deal of attention in architectural critique in Japan. This may be because the intense focus on the provision of medical functions made hospital buildings just monotonous. However, a hospital requires comprehensive environment development and the realization of a restorative environment. This chapter will discuss the general trend seen in the articles of Shin Kenchiku, Japan Architects, and AIJ Work Selections and will clarify the unique designs in a number of hospital buildings. The first case study is a large-scale and multi-function development resembling a townscape. Tokyo Metropolitan Fuchu Medical Plaza with 1,350 beds has a variety of functions and is serviced by a full spectrum of facility management. The second is a healing environment in Aichi Children’s Health and Medical Center, which was presented in a British architectural magazine, Hospital Development, in 2008. The third is the design of a dilettantish and unique approach by Atelier Architects, Katta Public General Hospital.
Key issues in hospital architecture critique
British building appraisal tradition
Becker (1990) acknowledged British building appraisal to be a tradition of balanced evaluation of building performance. The impressive book we remember is Stone’s British Hospital and Health-Care Buildings, Designs and Appraisals (1980) where British hospitals were introduced by “Architect’s account” and evaluated in “Appraisal” by another expert. Stone’s book (1980) consisted of articles originally published in The Architects’ Journal mostly in the 1970s. This approach has been adopted widely around the world. In Japanese architectural journalism, Shin Kenchiku, the most widely read architectural magazine in Japan (with its English translation issues as Japan Architects), presents monthly critique in its series of issues. The articles of AIJ Work Selections have been published annually by the Architectural Institute of Japan since 1989. They consist of introductions by the architect, and appraisals by other experts. However, one shortcoming is that hospital architecture is not discussed in detail. Lastly, it should be noted that the Journal of Japan Institute of Healthcare Architecture was first issued in 1968, and has reported on newly built health care facilities with explanatory photographs and drawings, including articles and research papers. The authors played responsible roles in the design of hospitals which were published in the journal and one hospital received the first Healthcare Architecture Award by the Institute in 1991. Although a review of planning and design features of awarded hospitals would suit the purpose of this chapter, the authors have decided to keep that task for another occasion.
Hospital as a city
Northwick Park Hospital and Clinical Research Center, designed by John Weeks of Llewelyn-Davies Weeks, is the first deliberate attempt to design a modern hospital with no finite form (Stone 1980). In this project the architects showed a piecemeal growth of the hospital complex as a “village.” This was introduced in Japan by Professor Yasushi Nagasawa and became a strong supporting argument to provide for future growth by clarifying the main circulation corridor in a hospital complex as a “hospital street” as in a village main street.
Fuchu Medical Plaza was introduced in Shin Kenchiku (July 2010 edition). It is certainly one of the largest hospitals in Japan with a total of 1,350 beds. It is a complex of two hospitals, namely Tokyo Metropolitan Tama General Medical Center and Tokyo Metropolitan Pediatric General Medical Center. The development and operation program has been carried out as a private finance initiative (PFI) of the Tokyo Metropolitan Government. The average number of facility users totals over 6,000 persons per day, including staff and over 2,000 outpatients. Having outpatients of this magnitude in a hospital may be considered a significant speciality in Japanese hospitals.
An article of interviews among architects of hospital projects has appeared in Shin Kenchiku titled “Hospitals in connection to Townhood,” discussing design issues related to users’ comfort, including wayfinding. To a limited extent some works by Professor Roger Ulrich have also been introduced.
Evidence-based design
The authors would like to discuss an article which appeared in the distinguished British architectural magazine, the Architectural Review (Finch 2005a). Paul Finch, who was an Architectural Review author at that time, starts his essay by introducing Professor Roger Ulrich and evidence-based design which showed that certain environments can help patients recover more quickly, using fewer drug treatments. When compared to the US and UK, Professor Ulrich has not yet achieved a strong presence in Japan. It has been pointed out that the above-mentioned drug treatments are seldom used in Japan, so that the validity of research has been questioned. This view is quite strange in the sense that if the treatment is meaningful in a certain society, the issue of quantity is a matter of decision-making. However, when Ulrich’s theory was first introduced in Japan, a certain Doctor S. Haruyama had already published in Japan a book entitled A Great Revolution in the Brain World (1995) which sold a million copies. He proposed a new type of health care facility where nurses wearing kimonos welcomed a patient, based on the principle that “Illness is the result of consciousness,” a Japanese saying. Looking for more construction work in health care, representatives of general contractors and subcontractors crowded into this doctor’s office. However, they found that it was only an empty idea.
FIGURE 17.1 A picture book on the journey of Marron Sister and Acorn Brother
Source: Akikazu Kato.
Healing environment
Japan has a long history of healing environments and healing gardens. The first Buddhist temple established for healing purposes was Yakushiji in Nara. Yakushi means pharmacist. In the year 680 Emperor Temmu commissioned the project to pray for the recovery from illness of his wife, who succeeded him as Empress Jito. The temple was moved to the present site in 710, in coordination with the development of the ancient capital of Heijokyo.
Garden design was much improved in later temples such as the Ginkakuji, Temple of Silver Pavilion, in Kyoto. Shogun Yoshimasa Ashikaga initiated plans to for creating a retirement villa and gardens as early as 1460. It is said that Yoshimasa sat in the pavilion contemplating the calm and beauty of the gardens while the Onin War (1467–77) worsened and Kyoto was burned to the ground. After his death the temple became a Zen temple, Jishoji, named after Yoshimasa’s monk name.
However, the term healing garden may originate in the gardens of the Children’s Hospital at San Diego, in California, USA. “Carley’s Magical Gardens” are filled with bronze animals, giant buggies, and interactive play areas. The design is inspired by little Carley Copley, who was just a toddler when her battle with leukemia came to an end. A picture book was made from Carley’s memories, and her parents funded the project to build gardens to allow Carley’s spirit to live on. Cooper Marcus and Sachs (2013) introduced survey results of healing gardens and pointed out that unexpected uses by patients’ families and staff are also important.