Halcyon Hospitals

The latest in a series of tales inspired by past visions of a perfect future.

"A medical dream comes true," announced the 1953 newsreel Dream Hospital, extolling the virtues of an "ultramodern" $2 million medical facility in California. And what cutting-edge technology did $2 million buy then? Patient records transmitted by pneumatic tubes, a combination X-ray/fluoroscope ("imported from Holland at a cost of $25,000"), and newborn babies moving from nursery to mother's room via something that looked very much like a file cabinet drawer. Meanwhile, patients passed the time by a courtyard swimming pool. "Dream grounds for a dream hospital!" gushed the newsreel.

Half a century later, many hospitals still use pneumatic tubes, now electronically controlled. But in most respects, Dream Hospital barely hinted at future advances. "Ninety percent of the technology in today's hospital wasn't available, and most of it wasn't even dreamed of," says Greg Mertz, president of the Horizon Group, a hospital consultant. "You didn't have dialysis, you didn't have chemo. It was, 'Oh shucks, you've got cancer,' and you're dead."

Even hospitals of a few years ago couldn't have predicted innovations like a combined CT/PET (positron emission tomography) scanner, used in oncology to gives diagnosticians a real-time look at tissue changes. Another breakthrough, says Mertz, is General Electric's 3.0 tesla MRI, which offers far superior image resolution.

Newer and more-powerful medical equipment can pose thorny problems for hospital design. "As a medical architect, you have to build for tomorrow, not for today, and that's tricky," says George Mejias, director of design and construction at New York's Memorial Sloan-Kettering Cancer Center. "These days, we're starting to see MRIs in the operating room, but nobody would have thought of that five years ago, so they wouldn't include all the infrastructure--the power, the piping, the ceiling clearance, the structural supports, even the square footage. And if those aren't there, then you're looking at huge costs to renovate."

But the biggest challenge hospitals may face is that medical advances could render entire wards--and profit centers--obsolete. "Hospitals will have to reinvent themselves as smaller entities that are just subsets of what they do now," says Mertz. But even a smaller hospital will cost a lot more than the facility in Dream Hospital. "Two million dollars? That buys you maybe one MRI machine," says Mertz. "For the whole hospital, figure at least $300 million." Plus a bit more for the swimming pool.

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