College Student Reflects on Recent Academy Lecture

Today’s guest post is by Eliana Lanfranco, who is a rising sophomore studying at Georgetown University. She is majoring in medical anthropology and hopes to pursue a career in medicine in the future with the aim of returning to her home country to open a clinic. Eliana attended the Academy lecture with Project Rousseau, a non-profit organization, whose mission is to empower youth in communities with the greatest need to reach their full potential and pursue higher education. Project Rousseau takes a holistic approach to students’ educational problems delivering a variety of programs and strongly believes in the importance of exposing students to as many new experiences as possible, such as attending lectures at the New York Academy of Medicine!

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Eliana Lanfranco (center) with Project Rousseau Founder and President, Andrew Heinrich, and two younger Project Rousseau students.

On May 11, I attended “Facades and Fashions in Medical Architecture” at the New York Academy of Medicine.  This was my first time attending a lecture outside of my college classes, and I left with a different perspective on what lectures have to offer. The lecture did not contain slides filled with information I was required to know for a course, but rather an interactive, engaging talk filled with information I wanted to know. Through it, I learned about a new side of the history of medicine that I had never thought about before.

The lecture began with an overview of dispensaries, which were used primarily by the lower income groups in NYC (the wealthy had their own private doctors) in the 19th and early 20th centuries.  Many of the volunteers in these dispensaries were doctors from affluent backgrounds who had recently graduated and wanted to gain clinical experience to become established doctors. Later, when hospitals began to serve both the poor and rich, recent graduates preferred the hospitals over the dispensaries, since the former had the latest equipment, such as x-rays and anesthesia, which the doctors could learn about and use.  It is interesting to see how this trend has, to some extent, remained among medical students today, and which medical institutions attract which students. Today, it may be easier to find a volunteer spot in community clinics than in hospitals, and medical students can oftentimes be more exposed to the health issues that affect certain communities who use these facilities.

The lecture also highlighted the way in which hospitals were built to be relatable to the patients and how their architecture reflected medical beliefs at the time. Older hospitals were built with long, narrow wings, as it was believed that the flow of air and light eliminated germs. Their architecture also tried to be welcoming and non-imposing to people walking past them; for example, mental health institutes were built to have a countryside feeling instead of looking like enclosed plots of land. Later, many of the hospitals built during the New Deal time period also featured murals painted by local artists in their waiting rooms. These murals were sometimes twofold, as they featured “controlled medicine” or modern medicine, and “uncontrolled medicine” or folk forms of healing. They portrayed historical figures in medicine, such as Louis Pasteur, and minorities in the field of medicine. As a patient, I would have been thankful for these murals since they offer some distraction from the endless wait in the waiting room.

In contrast, modern hospitals have been built in big clusters, along with skyscrapers. Their rectangular shape makes them reliant on mechanical ventilation, and their towering height makes them overpowering to people walking by. However, many try to maintain their air of welcome by making the entrances wide to show that it is not an institution for a select few. I think that these small details are very important because even though the majority of patients may not consciously think about the architecture they’re entering, these features greatly affect how patients, especially those who are not used to having structured medical systems in their home countries, feel about entering the hospital. I lived in a rural part of the Dominican Republic and the tallest hospital I saw growing up was four floors high. When I moved to New York City, I was surprised at the height of the hospitals and, although I am no longer a child, I am often intimidated by the buildings. It is good to see that some hospitals have incorporated details into their architecture to retain the air of welcome for patients, although as I, and many others, still quiver as we enter hospitals, I wonder how successful this approach has truly been!

Prior to this lecture, I was unaware that so many buildings I walked by every day, and that just looked like apartments with no historical importance, were actually hospitals and medical institutions.  Although older medical institutions can give us an insight into older medical beliefs and practices when carefully inspected  and can help us shape future medical practices, many of the older medical institutions have survived only through repurposing to other uses, such as apartments or firehouses; few have maintained their original purpose. It would be great to see the older hospitals that have survived, continue their original purpose or become museums so that their medical history can be saved, as has been the case with some buildings in nearby Philadelphia and Boston. As a pre-med student, the thought of attending an architecture lecture was, at first glance a little strange, but now I realize how related medicine and architecture are. A doctor’s primary aim is to treat all those in need, but without the right architectural design many patients may be hesitant to enter towering, intimidating hospitals!