Joerg Albrecht, MD, PhD
John H. Stroger, Jr. Hospital, Chicago, Illinois, United States
|The Klinikum Aachen with helipad|
The Klinikum of the Rhenish-Westfalian Technical University in Aachen (Aix-la-Chapelle) evokes reactions in everyone who sees it. As seen from the nearby rolling pastures of the Dutch border, its towers abruptly obstruct the countryside like a beached aircraft carrier. Even closer, viewed against an adjacent medium-size concrete city block, the building is set back, separated by large parking lots. Up close, the long façade with the metal railings in front of the windows and the six concrete towers topped by yellow striped pipes evokes oil refineries or chemical plants.
These colored pipes that now so characterize and dominate the impression of the building were not part of the initial plan. They were moved to the rooftops after the technical floors on the upper three bed carrying levels of the hospital were removed as an early cost saving measure.1 Exposing the difference between served and service spaces was pioneered by Louis Kahn about a decade before the Klinikum was planned. The Richardson Laboratory building on the University of Pennsylvania’s campus in Philadelphia was a relatively discreet affair, with the technical systems covered in brick and elegantly molded concrete. The Klinikum is less elegant and much larger. If it were not for the pipes, it would look much more like its more brutalist concrete cousin, the McMaster University Hospital in Hamilton, Ontario, finished in 1972. Now its colorful pipes point to Richard Rogers and Renzo Piano’s Centre Georges Pompidou, another younger family relation.
Like the Centre Pompidou and McMasters, the Klinikum is huge. It is 240 meters long and 160 meters wide, larger than Charlemagne’s eighth century palace complex that now forms the core of Aachen’s city center. A Klinikum is generally a collection of several medical university departments under one roof. In Aachen it is practically the whole medical school. According to its architects, Aachen’s Klinikum is a “machine”,2 but it is even more; it is Archigram’s “Plug-in-city”.2;3 This city was to be served by an infrastructural “megamachine” that residential units plug into, much like the different departments and wards plug into the technology core of the Klinikum. The “Plug-in-city’s” bare pipes and steel construction celebrated visual incompleteness, an aesthetic reminiscent of the construction boom after the Second World War, not of traditional English architecture or the lush Garden city.3 Currently, buildings such as the Klinikum are known as “high-tech architecture”, and the Klinikum is arguably one of the finest examples of this type.
Hospitals are some of the most complex buildings in existence, huge and technically difficult to plan and construct. Simply by its size the Klinikum is a true megastructure. To build it as a “Plug-in- city” was not easy, and to live with it was not easy either, but is now paying off. When the new university hospital was planned in 1969 it was to be the fitting addition to one of the world’s premier technical universities, ultramodern, flexible, and technically advanced. In order to achieve this goal during a long construction process, the planning was done in stages. The relatively simple ward structures with their bathrooms and nursing stations were finished first. The rest of the building was planned and built successively. However, this iterative process turned out to be more complex than anticipated, as medical technology and building codes changed rapidly.4 For example, preplanned structures, particularly solid walls, had to be changed into glass partitions when the updated code mandated more daylight for the offices and laboratories that were in the core of the building. This solution was complicated, but it pacified the regulators. Glass walls, however, did not sit well with the workers, who wanted privacy at work and have since covered most of the glass with posters and pictures to make them as opaque as possible.
The Klinikum became the object of intense public interest as the costs spiraled out of control. The initial estimated costs in 1969were 620 million marks. When officially opened in 1985, much later than planned , the costs had risen to 2.4 billion marks. Planning mistakes are inevitable with a project of this size. As an example the air conditioning system had to be changed when it became apparent that the air intake as planned collected diesel fumes from the streets and parking area in front, rather than provide fresher air from the fields at the back. When the hospital finally opened, more overreach of technical ambition became apparent, most palpably when the innovative transport system failed to live up to expectations.5 Some 3.5 km of tracks were laid to move boxes throughout the hospital to deliver blood samples and surgical supplies in real time to the operating rooms. Because of its unreliability, many blood samples have to be hand delivered to the central laboratory, and new storage rooms had to be constructed close to the operating rooms, displacing other operating rooms in the process.
The hospital’s air conditioning was a rather grandiose affair, a system that mixed warm and cool air in each room to achieve the right temperature. It reportedly cost as much as the hospital itself was meant to cost when first envisaged. It is a peculiarity of German taste, but patients and physicians never got used to air conditioning because they wanted to open windows to let in fresh air. Now air conditioning is slowly being removed from the patients’ rooms on the the top bed floors to allow the windows to be opened.
When the hospital was finally opened, it turned out to be a good place to be. Today it is a success. Its flexibility has made it possible to adapt the building to new needs. Hospital rooms have been enlarged and wards reconfigured to meet more recent standards. What has not changed is that all clinical departments are in one building, joined by most of the clinical sciences. This concentration, often technologically difficult to achieve, makes communication quicker, ways shorter, life easier and medicine better. It allows cost conscious energy management and facilitates logistics. Its recognition as a national monument recognizes this achievement and the need to preserve it.
I want to thank Dr. Lutz Meyer for helpful input into this manuscript
- Hoffmann G. Universitaetsklinikum der RWTH Aachen – High-Tech-Architektur fuer ein Krankenhaus. In: Mainzer U, ed. Jahrbuch der Rheinischen Denkmalpflege 40/41. Worms: Wernersche Verlagsgesellschaft; 2009;31-49.
- Meyer L.H., Albrecht J. Kliniken und Krankenhaeuser in Aachen. Zetischrift des Aachener Geschichtsvereins 102, 413-443. 1999.
- Merin, G.: AD Classics: The Plug-In City / Peter Cook, Archigram http://www.archdaily.com/399329/ad-classics-the-plug-in-city-peter-cook-archigram/ accessed on 2-17-2014
- Zander E.H. Das Klinikum Aachen. In: Flaage I, ed. Architektur in der Demokratie: Architektur des Staates. Eine kritische Bilanz staatlichen Bauens in Nordrhein-Westfalen von 1946 bis heute. Kleve: Boss-Druck und Verlag; 1986;74-84.
- Editor Maak K.J.: Erco – Lichtbericht 25 http://www.erco.com accessed on 2-19-2015
JOERG ALBRECHT studied medicine and history of architecture at Aachen/Aix-la-Chapelle, Johannisburg, and Cambridge. He has worked in Germany, the UK and the US and trained in clinical pharmacology, internal medicine and dermatology. He now works as a dermatologist at the J.H. Stroger Hospital of Cook County.