My personal interest in twentieth-century hospital design comes from imagining a history of medicine from built sources, rather than relying solely on written texts. My doctoral research had touched on this challenge through an analysis of women, doctors, and late-nineteenth-century house design. Hospitals seemed like a logical next step from the healthy house. Were hospitals catalysts in the development of modern medicine? Or were they, as many architectural and medical historians had assumed, simply passive reflections of medical innovation? The sheer volume of buildings constructed between the wars, too, demanded scholarly attention. The 1920s saw an enormous growth in the...

In 1893, Montreal was a deeply layered city. Framed by the mighty St. Lawrence River and picturesque Mount Royal, the city from a distance appeared as a dense, sloping grid of tiny, attached houses. Monumental, gable-roofed churches with towers and bulky religious and educational institutions, especially monasteries and convents, punctuated the layer of flat-roofed houses and provided clear visual hierarchies in the mostly Catholic, French-speaking metropolis.¹ So, too, did the splendid commercial structures of the early twentieth century. A 1906 panoramic view of the city showcases the city’s commercial growth from the old city at the river’s edge, toward the...

In one of a series of articles anticipating the American Hospital Association conference in Montreal in October 1920, the influential Chicago-based journalModern Hospitaldescribed the four-year-old Ross Memorial Pavilion at Montreal’s Royal Victoria Hospital as “the final word of the day in hospital construction and architecture.”¹ Photographs of the hospital (Figure 2.1) taken from a distance show how Boston-based architects Stevens and Lee, North America’s most prominent hospital architects, sited the Ross Memorial Pavilion to appear as a kind of crown to the older hospital. Located just behind and above the pavilion-plan building, as the photograph shows, it blurred...

The architecture of the Royal Victoria Hospital nurses’ residence embodies two powerful ideological forces: the “bourgeois ideology of femininity,” which attempted to “contain womens’ work outside the home within the duties of homemaking,” and the reformist drive to professionalize nursing, which attempted to valorize women’s work inside the hospital by grounding it in theoretical and scientific training.¹ While the building’s eclectic ornament and domestic spaces were intended to attract middle-class women to join the ranks of the growing profession, these same architectural features simultaneously limited women’s participation in the world of health care to the same roles they played in...

The preceding chapters have taken us on selected tours of the hospital, from the drafty, open wards of the sprawling pavilion-plan hospital of 1893 to the luxurious private patients’ quarters of 1930. Along the way, we have stopped to appreciate why children’s and women’s hospitals are both separate from the main hospital (yet in different ways and for different reasons); why nurses’ residences look like houses; and what a billiards table says about medical education, among other places and questions. Chapter 5 will synthesize some architectural features and ideas our detailed tour missed, summing up the changes in design the...

This final chapter explores the architecture of Edward F. Stevens and his partner, Frederick Clare Lee, during the 1920s, a critical period of expansion in the history of the North American hospital. Stevens and Lee’s work is representative here of a whole wave of modern institutions that incorporated and promoted social and medical change. Driven by the changes and tensions outlined in chapters 2, 3, and 4, the key features of the modern institutions included historicist imagery, steel and reinforced concrete framing, fireproofing, soundproofing, functional zoning, overt references to domestic and hotel architecture, delivery by automobile, internal communication technologies, adherence...