How the atmosphere of a building affects patients

Unit Title : Dissertation

Word Count: 5396

Unveristy of Portsmouth
2015

CONTENTS

List of Illustrations

Introduction

Chapter 1 - Plants and nature

14

Chapter 2 - Colours and Materials

21

Chapter 3 - Scale

26

Conclusion 31
Post Script

33

Biblography 34

LIST OF ILLUSTRATIONS

Figure

1a-c, 4-6, 10-12, 14, 16-19,

23, 24, 27, 30-32, 34, 35
37-39, 42, 44, 45, 50, 51
54

Primary source - Own work

Figure 7-9, 13
Dezeen. (2011). Champalimaud Centre for the Unknown by charles
Correa Associates. Retrieved 2 January 2015, from http://www.dezeen.
com/2011/06/14/champalimaud-centre-for-the-unknown-by-charles correa-associates/
Figure 2, 20, 40,
Maggies. (n.d.). The architecture and design of Maggies West London.
Retrieved 2 January 2015, from https://www.maggiescentres.org/our centres/maggies-west-london/architecture-and-design/
Figure 15, 46, 47, 49
Rogers Stirk Harbour + Partners. (n.d.). Maggies Centre. Retrieved 2
January 2015, from http://www.rsh-p.com/render.aspx?siteID=1
Figure 21, 22, 29,
McIntyre, T., bdonline.co.uk. (2008). Rogers Stirk Harbours Maggies

Centre at Charing Cross Hospital is a place like home. Retrieved 2
January 2015, from http://www.bdonline.co.uk/rogers-stirk harbour%E2%80%99s-
maggie%E2%80%99s-centre-at-charing-cross hospital-is-a-place-like-home/3112980.article
Figure 25
Redfern . (2104). THE WHICH INVOLUNTARY SURGICAL PROCEDURE

ARE YOU? QUIZ. Retrieved 2 January 2015, from http://www.redjon.
com/2014/04/involuntary-surgical-procedure-quiz/
Figure 26
www.fracademic.com. (n.d.). Serres royales de Laeken. Retrieved 2
January 2015, from http://fr.academic.ru/dic.nsf/frwiki/1530702
2

News in Mind. (2014). Secure mental health beds crisis. Retrieved 2

Figure 28
January 2015, from http://www.newsinmind.com/general-news/secure mental-health-beds-crisis
Figure 33
Design Curial. (2011). CHAMPALIMAUD CENTRE FOR THE UNKNOWN.
Retrieved 2 January 2015, from http://www.designcurial.com/news/
champalimaud-centre-for-the-unknown
Figure 3
The Temples of Consumption. (n.d.). Champalimaud Center for the
Unknown. Retrieved 2 January 2015, from http://
thetemplesofconsumption.blogspot.
co.uk/2012/11/charles-correa champalimaud-center-for.html
Figure 36
Nogueira, F., ArchTendncias. (2013). Centro de Pesquisas Champalimaud

/ Charles Correa Associates. Retrieved 29 January 2015, from http://
archtendencias.com.br/arquitetura/centro-de-pesquisas-champalimaud-
charles-correa-associates#.VMqQsGisVc4
Figure 41, 43, 52, 53
Mays, V., & Nogueira, D. (2011). Champalimaud Centre for the Unknown

Features a Glass Bridge. Retrieved 2 January 2015, from http://www.
architectmagazine.com/healthcare-projects/champalimaud-centre-for-the unknown-glass-bridge.aspx
Figure 48
Bryant, R. (n.d.). Maggies Centre. Retrieved 2 January 2015, from http://
ecola-award.eu/en/project/nb/maggies-centre

INTRODUCTION

Figure 1a - Atmosphere

In the Western World we spend 90% of our lives inside or within the
proximity of buildings. (Dyckhoff, Channel 4, 2011) It seems reasonable
to assume that the quality and atmosphere of this environment affects our
health. Through the use of 2 examples this essay investigates how this
understanding can be used in the design of space to have a beneficial effect
on our health and well-being.

Atmosphere as the purpose of architecture...
Gernot Bhme (Jaeger, 2007)

Swiss architect Peter Zumthor describes best what architectural atmosphere
is
...this singular density and mood, this feeling of presence, well-being,
harmony... under whose spell I experience what I otherwise would not
experience in precisely this way... (Birkhuser. 2006).

Figure 1b - Atmosphere

Contemporary architecture should be as radical as contemporary music

but as understandable as classical music. Architecture that is fragmented
and which creates an environment of disharmony will confuse, clutter and
kill our curiosity; however with the environment and atmosphere carefully
considered architecture can embrace our inquisitiveness and nurture our
well-being and health. ( Morphocode, 2013)
The Atmosphere that pervades architecture can have numerous effects
on our health. Architects need to not only recognise how the Atmosphere
affects us but also evaluate, understand and apply these ideas to future
buildings. Figure 1a-1b shows how a building influences our well-being and
creativity.

Figure 1c - Atmosphere

This essay will use 2 case studies; Maggies Centre West London:
Charing Cross Hospital designed by Rogers Stirk Harbour & Partners and
the Champalimaud Centre for the Unknown designed by Charles Correa
Associates in Lisbon, to compare against 3 common ideas; plants and
nature, colour and materiality and scale. This dissertation will explore how
the Atmosphere created in these buildings is used holistically to aid healing.
Both of these buildings are centers for the care of cancer patients and
cancer research. The patients receive medical treatment and complimentary
therapies such as, counselling and support. Although these buildings were
built for the same purpose they have completely different approaches to the
Atmosphere and how this can influence the health of patients.

Figure 2 - Outside the Centre in the summer

A building can have a vast impact on peoples health and their mental wellbeing. There are claims that fresh air, nature and natural light promote
healing and make people more focused and in a better frame of mind. Along
with these, the use of colours and materials can greatly affect our health and
ability to heal.

Figure 3 - Aerial shot of the Centre

THE CHAMPALIMAUD CENTRE FOR THE UNKOWN

The Champalimaud Centre for the Unknown is a state-of-the-art research

and diagnosis centre for cancer and brain damage located in Lisbon,
designed by the well-known Indian architect Charles Correa. Correa was
born in 1930 and his work seeks to be modern but firmly rooted in Indian
culture. His works have an emphasis on natural resources, energy and
climate as a method for organizing the spaces within the building.

Figure 4 - Map of Portugal

The site in Lisbon is located along the River Tagus just at the point where
it meets the Atlantic Ocean. The river has been key to the history of Lisbon
and Portugal as a whole. When the great navigators arrived at the mouth
of the River, it must have taken a massive act of courage to venture into
the open ocean, a journey into the unknown. Its a metaphor for not only
exploration but the building as well its a journey into the unknown.
Correas building was not to be thought of as museum of modern art but a
building of the highest levels of modern science and medicine to help people
overcome real problems such as cancer and brain damage. Correa says
To house these cutting-edge activities, we tried to create a piece of
architecture. Architecture as Sculpture. Architecture as Beauty. Beauty
as therapy... (Champalimaud Centre for the Unknown / Charles Correa
Associates, 2011)
The Building has 3 areas; the largest of these is the hospital complex
housing doctors, scientists and patients; the next area contains a theatre,
exhibition halls, offices and other general services. The last area is an open
air amphitheatre which was designed to serve the building as well as the
wider city.

Figure 5 - Map of Lisbon

The two main buildings are linked by a glass bridge, this helps to create an
Atmosphere of harmony with the site as a whole aiding the ideas of healing.
The buildings have been designed with a ramped 125m long route leading
across the site, through the landscaped gardens towards the open sea.
The landscaped gardens draws the user into the site and towards the
ramped route, throughout the gardens there are places for people to sit and
reflect, making a very attractive place for patients receiving treatment. As
you ascend you can only see the sky ahead of you but when you reach the
top you see two stone monoliths from the nearby quarry, these monolith
stone pillars create an Atmosphere of reflection and makes the space very
calm.
Behind these monoliths is a large body of water which connects, without
any visual breaks, to the ocean ahead of it. Just below the surface of the
water is a slightly convex oval object made from polished stainless steel; this
object reflects the sky and clouds making an Atmosphere of tranquility and
serenity.

Figure 6 - The building labeled

Figure 7 - Stone monoliths

Figure 8 - Ground Floor Plan

Figure 9 - First Floor Plan

Figure 10 - Concept drawings

Figure 11 - Stairs to the

Amphitheatre

Figure 12 - Stairway in the

reception

Figure 13 - Wall

Figure 14 - Inner rainforest garden

MAGGIES CENTRE WEST LONDON: CHARING CROSS HOSPITAL

IMAGes

Figure 15 - Concept sketches

10

Maggies Centres are run by the Maggies Charity, which provides support,
counselling and residential retreats for cancer patients. The charity was
set up in May 1993, Maggie Keswick Jencks was told that her cancer had
returned and was given only a few months left to live. At this point she
joined an advanced chemotherapy trial and contrary to what doctors
thought, she lived for another 18 months.
Before her death in June 1995, she and her husband worked closely with
her medical team, to develop a new approach to cancer care. In order to
live more positively with cancer, Maggie believed you needed treatment
which included stress-reducing strategies, psychological support in a relaxed
domestic setting. Maggie realized that the cluttered confusing spaces found
inside modern hospitals were creating more stress and making it harder
to deal with cancer, but in a more relaxed setting these problems were
diminished.
Maggies husband, Charles Jencks is an American architecture critic and
theologian who specialized in landscape architecture and sculpture. Charles
thought it important that nature played a large role in the healing process of
cancer patients, so all of the Maggies centres are surrounded with serenely
planted gardens. The gardens allow the patients to experience the healing
qualities of science found in nature and the spirituality that nature can show.

Figure 16 - Map of the UK

Charles explains his ideas and theories as

...To see the world in a Grain of Sand is to find relationships between the
big and small, science and spirituality I explore metaphors that underlie
both growing nature and the laws of nature... (Charles Jencks, n.d.)
This idea of looking at the big and the small is an idea carried across every
Maggies Centre.
Figure 17 - Map of London

11

In November 1996, the first Maggies Centre opened in Edinburgh. Since

then 14 new centres have opened, each one being designed by a celebrated
architect. The Architect for the West London Centre was the practice of
the world renowned architect Richard Rogers, Rogers Stirk Harbour +
Partners; the practices ethos is to try and reject the ideas of the past, whilst
encouraging a technological future, and wherever possible using modern
technologies to enhance the environment within a building. Throughout
his work Rogers tries to incorporate designs and concepts from the early
modernistic movement.
Rogers concept came from the idea of a heart being protected by 4
supporting walls
Figure 18 - Entrance to the

Centre

...The idea was to try to minimise the overbearing impact of Charing Cross
Hospital. The roof, the landscaping, the hearth inside, the views out, each
was to take you away from the hospital and the bustle of the road... (The
architecture and design of Maggies West London, n.d.)
The West London Centre is a two story pavilion with a grand hovering roof
canopy that reaches high above the walls creating a protective environment
over a series of intimate internal courtyards and gardens.

Figure 19 - Outside in January

The exterior of the building is covered in a deep orange render which puts
a protecting arm around the core of the building, making it its own place
without denying it is a part of the surrounding city.
This approach was taken to make it feel like an open house within the city,
retaining Maggies idea that cancer patients would benefit from receiving
support in a more domestic setting, surrounded by gardens and thoughtfully
designed landscape to form an homely Atmosphere where a person can
really focus on themselves and their treatment.

Figure 20 - Looking into the kitchen

12

Figure 21 - Ground Floor Plan

13

Figure 22 - First Floor Plan

CHAPTER 1 PLANTS AND HEALING

Figure 23 - Greek Temple

The Ancient Greeks (8th Century BC) recognized the benefits of nature
and plants in the healing process. Temples to the God Asklepios, the God
of Medicine, were designed to surround patients with plants and nature to
create an Atmosphere of healing and harmony.
The Ancient Chinese (16th Century BC) studied the natural environment,
developing Feng Shui,
the most favorable location of both people and things in a particular
environment (Schweitzer, Gilpin, & Frampton, 2004).
Feng Shui works with Chinese medicine and Ying-Yang, every building and
person is believed to have its own unique energy and these energies are
enhanced by the natural environment and the plants planted nearby. Chi,
gives life, it is the difference between being a corpse or being a living being.
Having more Chi can enhance a persons health and their mental well-being
(Energy Arts, n.d.). Promoting good Chi and creating the right Atmosphere
by harnessing the ideas of Feng Shui can have a substantial impact on the
health and well-being of patients.

Figure 24 - Monastic cloister

During the middle ages, Monasteries were the driving force behind medical
advances offering healing to all levels of society without discrimination,
royalty and peasants alike visited monastic gardens for healing and the
tranquil environment they instilled.
In the Nineteenth Century, Florence Nightingale documented the negative
effects of poor hospital design by observing the survival rate at different
facilities. She noted that there was a lower survival rate when the hospitals
were over crowded, had poor ventilation and werent connected to nature.
14

Right from the 2nd millennium BC to the 21st century Botanical Gardens
have been in existence and are places where plants are collected, cultivated
and displayed; the gardens contain an array of different plant species from
many different countries, with the focus of preserving plants from around
the world. Botanists brought back seeds and plants and grew them in
specialised environments, mimicking the place of origin. It enabled the West
to gain the knowledge of how plants can be used to aid the healing process,
but inadvertently Botanical Gardens became a place of healing with many
people visiting them for the tranquil environment they create.

Figure 25 - 19th Century hospital ward

Gardens and plants have played an important role in history, they have
enabled us to create Atmospheres of healing but also to bring knowledge
from all over the world on ways to improve nature and the healing
environment they create.
The effects noted by Florence Nightingale and seen in Botanical Gardens
have been further recognized today with studies showing how three to five
minutes spent looking at spaces with trees, flowers or water can reduce
anger, anxiety and pain, it can also help relaxation, blood pressure, and
brain activity (Sternberg, 2010).

Figure 26 - Typical Botanical garden

A 1993 study carried out by Uppsala University Hospital in Sweden selected

160 intensive care patients and introduced them to six different conditions
after undergoing their surgery; simulated windows showing an open,
wooded stream or a shadowy forest, abstract paintings, a white or blank
wall. The survey proved that patients who viewed the stream scene were
less anxious and needed fewer doses of medication than those who looked at
the abstract art, shadowy forest, or blank wall.

15

Figure 27 - Uppsala University study, Does nature have an

effect on healing of patients?

Figure 28 - 21st Century hospital corridor

The advancement of medicine during the 20th and 21st centuries focused
on diagnosing, curing and treating. Critics have said that hospitals and
clinics have overlooked the fact that these advances bring negativity;
noisy, cluttered, institutional places with very little access to nature, and
minimal interest in the effects of these techniques on the patients physical
and mental wellbeing. Hospitals have become intimidating, dehumanizing
institutions with multiple unclear entrances, disorientating circulation
patterns, vague signage and significant restrictions on visitors and plants,
creating an Atmosphere of confusion and oppression causing patients
to feel more anxious and unwell; evidence shows that staying in hospital
following a short operation can increase postoperative pain and anxiety
(Franklin, 2012).
To combat criticism, hospitals need to be rationally planned and have
clear signage, they also need to be designed so they create small spaces
surrounded by nature where a person can sit and enjoy the surroundings
enhancing their healing ability but also reducing anxiety and stress. In a
recent survey of architects and hospital directors, 82 percent agreed that
...the design of outdoor space should be one of the most important
considerations in the design... (Franklin, 2012)
Nature in hospitals creates an Atmosphere of healthy, clean living with
the aim of promoting wellbeing. Architects and hospital directors now see
how having access to nature can greatly improve staff efficiency levels and
reduce recovery time for patients.

16

PLANTING IN THE MAGGIES CENTRE WEST LONDON

A fundamental part of all Maggies Centres is the landscaping. In the West

London Centre the purpose is to bring the standalone building into the wider
hospital site, while creating a distinct environment around and inside the
building to generate a therapeutic Atmosphere that adds to the healing
potential of the building.
The landscaping draws together the existing hospital and the new centre,
wrapping the buildings in trees to lower the noise and pollution levels whilst
keeping a leafy backdrop from the inside; these trees also help create an
ever changing streetscape that contrasts itself against the rust red coloured
building. The landscape helps reduce the fear of the hospital and creates an
Atmosphere that is focused on the Centre instead of the hospital complex.

Figure 29 - Nature surrounding the Centre

The building is approached from the hospital; a woodland walk leads to the
building between trees that have been surrounded with decorative plants,
ending in a public courtyard surrounded by white Magnolias which blossom
in spring. Figure 30 shows the planting that surrounds the Maggies Centre.
When approaching the entrance to the building there are bamboo groves
and sculptures that provide the patients with a place to meditate and
contemplate. Inside the building, there are a series of small courtyard
gardens that create protected external rooms under the floating roof that
distinguishes the building from the street. All the rooms in the building open
onto an internal garden, providing nature and a calm space for patients.
All of this is achieved whilst using ideas of sustainability as the building is
naturally ventilated, creating an Atmosphere of wellbeing and healing. The
open spaces inside the building are lavishly planted and are designed in such
a way that starts the process of acceptance and restoration.
17

Figure 30 - Plan showing the gardens

Throughout the building Mediterranean herbs are grown to be used in the

kitchen, Patients are encouraged to help tend for these herbs.
The gardens are broken into three key areas: northern, eastern and
Southern winter gardens. These are an extension of the internal areas that
are only accessed from inside the building; the inner courtyard gardens are
planted with interesting year round plants to provide a level of interest no
matter what the season. As part of the therapeutic healing, patients are
encouraged to be actively involved in the maintenance of the gardens to
enhance their health.

Figure 31 - Trees planted outside the centre

Figure 32 - Section highlighting the planting

18

PLANTING IN THE CHAMPALIMAUD CENTRE FOR THE UNKOWN

When approaching the Champalimaud Centre the user is greeted by the

Jardim Anna Sommer - . The garden is a tribute to the founders mother;
the vast, green space was designed with the idea of using no boundaries
or fences, using grass helps indicate that the area has been returned to
the public. Along the stone pathway, trees are planted providing shade and
shelter from the Portuguese sun.
The interior garden was designed to be the most breath-taking part of
the main building. This garden is covered by a glass roof which creates a
microclimate that is ideal for plants from Brazil, Africa, India, and the Far
East. These plants are used to promote the idea of Feng Shui, it channels
the good chi promoting health and calmness, but also uses the idea of
a rainforest as a calm place to aid in the healing process. The interior
rainforest garden can be classed as a Botanical Garden, which ties the
design into the site, as Portuguese explorers used the river to access the
Atlantic sea.

Figure 33 - Interior Garden when built

A walkway guides the visitors through this exotic and tropical environment,
along the walkway there are rest areas to encourage the patient or visitor to
pause and enjoy the calming Atmosphere. This garden is open to the public
so that everyone can enjoy the peace and serenity of the lush green space.
Located inside the clinical building of the Champalimaud Centre is a Zen
Garden exclusively for the use of patients. This garden was designed
specifically so that the patients could be allowed to receive their treatment in
an Atmosphere of serenity and well-being whilst having a strong connection
to nature, which has been thought to aid healing.
19

Figure 34 - Interior Garden in 2014

To help create this Atmosphere the patients friends and family can
accompany them, turning a clinical procedure into a more enjoyable
experience.
The space was designed to bring the tranquility of the garden into the
hospital and create a place where nature takes a prominent role in healing.
Figure 35 shows where the gardens are located.

Figure 35 - Plan showing the gardens

Figure 36 - View into interior garden and treatment rooms

Figure 37 - Section highlighting the planting

20

CHAPTER 2 COLOURS AND MATERIALS

Colours and materials can also impact on our moods, outlook and mental
well-being. Each colour stimulates a different response from every individual
but there is some correlation between colours and the effect they have, this
is the same for materials.
A study undertaken by the University of British Colombia, looked at the
Blackfriars Bridge in London and suicide rates. It found that when the bridge,
made of iron, was painted green there was a 30% decrease in the number of
suicides. The study showed dark green, has a positive motivating effect on
an individual; males in particular.
The primary colours of red, yellow and blue each have a different effect on a
persons mood and mentality.
Red stimulates the adrenal gland and the neurons causing an invigorating
effect, however overstimulation can cause stress, frustration and anger.
Serotonin is a chemical in the brain that is essential for a happy mood
and positive mental outlook. Studies have shown that yellow can increase
Serotonin levels in humans but also enhance concentration and metabolism.
On the other hand, over stimulation has some negative side effects; short
temper and fatigue. Interestingly studies have found that babies cry more in
a yellow room.
Blue has a soothing effect on the brain, boosts creativity and denotes loyalty.
Materials that are blue, appear to be lighter, hence why heavier weights
are blue in a gym. But blue can cause depression and can been seen as a
cold colour, making a room feel cooler than it actually is (Human N Health,
2013.).
21

Materials can affect people as well as colours. In a study carried out by

the University of British Colombia, it was found that using wood, in a
room lowered patient stress and sympathetic nervous system activation.
Dark wood, such as mahogany, makes a space feel small and intimate; it
also gives a warming effect. Whereas lighter materials, European Oak for
example, makes a space feel open and airy.
The texture of a material also can have an effect on us. Smooth materials
are seen to be more clinical, expensive and clean; for example, polished
concrete. However, materials that have a rougher course texture, gives the
impression of being unfinished and cheaper. Rough textured materials can
also give an oppressive feel. The combination of colour, texture and finish
affects the individual in such a way; by material choice one can completely
change the feeling and sense of a space. (Allen Novak & Richardson, LEED
AP, AIA, and Glidden Professional, 2013)

22

COLOUR AND MATERIALS IN THE MAGGIES CENTRE WEST LONDON

In the Centre, the predominant aspect of the buildings approach to colour

and materiality is the wrapping rendered wall.
The bright rust red wall brings patients and visitors into an inspiring interior
with cosy intimate rooms, bright spaces and movable walls. The walls
provide changeable spaces that, give the ability to host anything from
intimate chats, to help overcome and accept diagnoses to exercise classes.

Figure 38 - Section showing rendered wall

Being a combination of red and yellow, Orange inherits the effects of both. It
is interpreted as a warm colour that helps well-being. Orange has a benefit
in all hues; it expresses nature, creates a feeling of playfulness and invites a
friendly happy Atmosphere.
The interior of the building has been designed so that it feels very familiar;
the flooring is made from polished concrete giving it a warm effect. All
the other aspects of the interior are made from wood, helping create an
environment of healing and relaxation.
All the woods are soft woods unless they need to be hard wearing such as
the door thresholds. The materials used in the project are natural and are
not inherently expensive, but its about the feeling they create. For example
the hand rails; an aluminum hand rail feels different to a hand rail wrapped
in leather, one is more clinical the other is more homely.

23

Figure 39 - The rust red wrapping wall

Figure 40 - Inside the kitchen

COLOUR AND MATERIALS IN THE CHAMPALIMAUD CENTRE FOR THE

UNKOWN
The Champalimaud Centre has a very modern clean feeling that can be
almost classed as clinical. Harmonizing with the idea of a modern lab the
curved buildings are built using Portuguese Lioz Limestone.
Portuguese Lioz Limestone has an off-white, neutral colour; white is used by
many medical institutions to show sterility. White also creates a comfortable
secure feeling; with its own gracefulness it implies stability and subtle
warmth. It also helps emphasize nature and a natural environment. (Allen
Novak & Richardson, LEED AP, AIA, and Glidden Professional, 2013)
Figure 41 - View into the medical building

The pathway that leads you through the Jardim Anna Sommer is made from
granite cobble stones in keeping with local tradition; whilst in contrast, the
inside of the buildings is floored in ceramic tiles, again giving a very modern
feel.
At the top of the pathway two concrete monoliths frame the view of the
small pool with the stainless steel convex oval object just breaking the
surface of the water and the Atlantic Ocean behind, helping connecting the
buildings to the wider site.
In the main medical building there are elliptical double height cut outs in
the walls, providing visual connections to nature and outside but also to the
different floors in the building.
The interior Rainforest garden is encased in floor to ceiling glass panels
which bring the outside into the treatment centres. Connecting the medical
building to the exhibition hall is a 21 meter long glass bridge supported
by tension cables. The glass is laminated curved glass to give the user the
feeling of nothingness and a true connection to the site as a whole.

Figure 42 - The pathway towards the sea

24

When the sun hits the building the Limestone shines with warmth that helps
the patient to feel at ease but also highlights the nature and beauty of the
space.

Figure 43 - View towards Lisbon

Figure 44 - Section showing the Portuguese

Limestone

25

CHAPTER 3 SCALE

...Ceiling height affects the way you process information ... Youre focused
on the specific details in lower ceiling conditions... (Anthes, 2009)

Figure 45 - How room size affects creativity

The scale and size of a space has a huge impact on peoples health but also
their mood. In 2007, the University of Minnesota conducted a study to see
if there was a connection between ceiling height and how people think. 100
people were selected to be in one of two rooms, one room had a 2.5 meter
ceiling and the other a 3 meter ceiling. In the rooms participants were asked
to group 10 objects into their own categories. People in the room with a
higher ceiling came up with more abstract categories and the people in the
smaller room came up with more concrete rational categories. Figure 45
illustrates this study. Higher ceilings makes people feel much less physically
and mentally constrained.
The study showed that people could think more freely and have a better
calmer outlook in a room with a higher ceiling, but lower ceilings prompted a
more detailed, statistical outlook.
...If youre in an operating room, maybe a low ceiling is better. You want
the surgeon to get the details right... (Anthes, 2009)
The way a building is designed, can create playfulness within the building.
By changing the heights of the ceiling and the scale of the rooms, the
architect can have a vast impact on our mental and physical well-being.
When it comes to medical centres, many of them try to save space and thus
have lowered ceilings.
This can enforce the idea of an establishment, but also hinder the patients
healing ability and detract from the Atmosphere of the space.
26

SCALE IN THE MAGGIES CENTRE WEST LONDON

Retaining Maggies ideas, the Centre has been designed to create an

Atmosphere of homeliness and warmth. You can see in figure 48 how the
spaces in the building are formed, it shows the entrance with the double
height space and the rest of the buildings. The counselling rooms have an
intimate feeling with the use of warm concrete and wood but also slightly
lower ceilings. Whereas the entrance to the centre welcomes you with a
double height space and exposed materials with large expanses of glass,
which leads to some more enclosed rooms where the materials are more
subtle and create a warmer Atmosphere. For example, the kitchen has a
lower ceiling and a warmer colour palate allowing patients to focus on the
healing process of cooking but also encouraging stillness.

Figure 46 - The flexible spaces

inside the Centre

On the other hand, the dining room, located next to the kitchen, has an
open double story height ceiling with lots of glass and all the materials
exposed, these exposed materials have a calmer, happier, cooler feeling than
those found in the kitchen; even though they are the same materials.
This creates an Atmosphere of openness and well-being, helping the
patients to talk and accept their diagnosis in a friendly setting. Inside the
intimate spaces there is at least one wall that doesnt fully touch the ceiling,
so even in these more enclosed areas there is still an Atmosphere of
openness.

Figure 47 - View from the entrance

Throughout the building, the architect has taken full advantage of the
floating roof, in the full height spaces it boosts the Atmosphere and
enhances the quality of the spaces but in the lower height spaces it
increases the feeling of comfort and being at home.

27

Figure 48 - Section through the building

Through the use of scale, the Centre creates a feeling of tranquility and
serenity, where a person can really focus on themselves. It allows the
patient to come to terms with their diagnosis and realize what is important;
their treatment, healing and well-being.

Figure 49 - The Floating roof

Figure 50 - Section showing different heights

28

SCALE IN THE CHAMPALIMAUD CENTRE FOR THE UNKOWN

Being a medical treatment and research facility, the Champalimaud Centre

has many aspects to the design that use different scales to create different
effects.
From the large open spaces of the atrium and gardens to the more focused
laboratories and treatment rooms shown in figure 51. The whole building
is very thought through, so the treatment rooms create a calm and safe
environment promoting health and well-being, whereas the public spaces
welcome and encourage movement and exploration.

Figure 51 - Section showing different heights

When approaching the building the sense of scale is impressive, the first
thing that you see are the large medical building and the theatre building
both made from the Portuguese Limestone linked with the glass bridge.
As you walk along the pathway, the public building takes a less prominent
role and the medical building retains its large limestone wall. In the walls are
double story elliptical cut outs. This gives the walls a transparent feeling; the
public can see in and the patients can see out without feeling spied on.
However as you reach the top of the path, right in front of you there are
two enormous concrete pillars that dwarf their surroundings and focus the
eye onto the ocean in front. Upon entering the main medical building the
reception is a double height space with huge expanses of glass either side
which gives the whole entrance an Atmosphere of modern clean openness.
The glass roof to the inner rainforest is nearly 30m in height, enhancing the
idea that the space is a rainforest and helps the plants to grow. However
in contrast to this, the treatment rooms which face this garden, have a
lower roof with calm natural colours and textures creating a modern medical
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Figure 52 - Double story cut outs in the medical building

centre where people are focusing on healing. Whislt using scale to have an
impact on the Atmosphere of the space, the Champalimaud Centre has a
consistent Atmosphere of healing and well-being

Figure 53 - Interior medical building, showing the glass

Figure 54 - Height changes in the buildings

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CONCLUSION

In conclusion planting, colour and scale each make a difference to a persons

health and well-being but when they are combined they have a huge effect
on the Atmosphere of a building and its users. Both buildings approach
the 3 topics in different ways. They use the idea of nature and gardens for
the same result, to maximize the patients ability to get the most out of
their treatment. Architects not only now realize how important nature is in
the healing process but are also starting to evaluate, understand and apply
these ideas to contemporary medical buildings. People are realizing that
the Atmosphere of a building and the use of nature can improve the life of
cancer patients.
Materials and colours vary between the buildings, the Maggies Centre
focuses on creating a homely feeling that makes the patient feel at ease
through the use of warm materials that would not be out of place in the
home, whereas the Champalimaud Centre creates a modern feeling with the
emphasis on healing through connecting to nature and the wider site but
also the use of neutral coloured limestone and large expanses of glass.
Using the ideas of colours and their impact on us, is nothing new but
architects are now using it in a modern way so that it has a positive impact
on our health, well-being and perception of a building and the Atmosphere
they create. Both architects use colour to create an Atmosphere, that is
unique to their building.
Whereas the approach both architects take to the scale of the buildings
is completely different, Rogers keeps the ideas that Maggie thought was
important making the centre feel like a home. Using mezzanine floors
to break up the double height to create a homely Atmosphere. Drawing
on his modern background Correas design is grander in scale with a clear
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focus on healing, the openness of his design makes for a light airy interior.
Throughout the building there are subtle hints to the scale and how it has
been designed, the stone and glass panels are overly large helping reinforce
the idea that people in the centre are working to solve a larger problem.
A key aspect which makes each building a success, is that each architect has
taken the location into careful consideration when making choices on the
surrounding nature, colours and materials and the overall scale. In London
the light generally is softer and cooler, which would make a white building
feel cold and oppressive but orange will bounce the light making a cold day
feel warm and no matter the weather, create a welcoming environment. In
Lisbon you wouldnt have these issues as the Mediterranean light has more
warmth and colour in it, so a white building doesnt feel cold but can feel
comforting and welcoming.
From this essay it is clear that our health is affected by the environment
and particularly the buildings that surround us and the Atmosphere they
create. From the very beginning of human civilization right to the present
day people have realized that some part of our surroundings and the
buildings included in them effect our mental and physical well-being. Even
Neanderthals decorated and interacted with the environment they were
surrounded with; creating paintings that depicted their lives and nature.
Many architects are learning from the past and accumulating this information
to make buildings that are more sensitive to their effect on humans and their
ability to heal.

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POSTSCRIPT

The NHS are spending over 5 billion each year treating cancer patients and
the cost to society as a whole is in excess of 18 billion (Ellison, Department
of Health, 2013). But by implementing the knowledge that architects are
gaining about how the environment and Atmosphere can affect our healing,
this can greatly reduce the cost by maximizing the efficiency of treatments
and reducing post-operative care needed. This can only lead to more
considerate buildings with the patients as the key focus.

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