CommissionThe Women’s Hospital and Maternity Center at Northwestern Memorial Hospital (eventually named for Abbie and Rockefeller Prentice) was conceived of as a major step forward in the care and treatment of women and babies in the city of Chicago. It consolidated the resources, knowledge, and services of Northwestern Memorial Hospital, the Chicago Maternity Center, and the Department of Obstetrics and Gynecology at Northwestern University Medical School and created a new kind of medical center that combined cutting edge technology, groundbreaking medical research, and patient-focused care. As advertised in a promotional pamphlet distributed by NMH at the time of the building’s completion, many of the services offered at the new hospital were not available anywhere else in the city. While Northwestern Memorial Hospital and the Northwestern University Medical School were well-established institutions in the field of traditional medicine, the Chicago Maternity Center was a smaller and more radical institution – although one with a history stretching back to the nineteenth century. Originally a proponent of home birth, by the 1970s the Maternity Center had shifted its approach to providing neighborhood-level resources to underprivileged women. By combining forces with Northwestern, they could bring their patient-focused approach to women’s health and childbirth to a much wider portion of Chicago’s population.The instructions provided to Bertrand Goldberg Associates (BGA) by NMH required that the building have a maximum annual capacity of 6,000 deliveries, 3,000 gynecological operations, and 33,000 outpatient visits. It would also need to house research facilities and administrative offices. To this end, NMH requested 60 gynecological beds in private rooms, 21 obstetrical beds in private rooms, and 78 obstetrical beds in double rooms clustered in suites. They asked that facilities be included for a variety of functions: dietary, pathology, data processing, central sterile supplies, blood bank, laboratory, medical art, heating and cooling, central storage and receiving, radiology, laundry, pharmacy, emergency, medical records, parking, teaching, and animal quarters. To help the architects make sense of the complexity and specificity of the building’s program, NMH provided schematics to show the necessary flow of people and resources in seven different types of spaces: administrative and public, ambulatory care, delivery and operating room suites, dietary, service and maintenance, and research. (Program of Requirements and Instructions to Architect accessed at the Bertrand Goldberg Archive at the Ryerson Library of the Art Institute of Chicago)One of the most exciting features of the new hospital, according to Prentice’s promotional pamphlet, would be the introduction of what they called Family-Centered Maternity Care. Inspired by the idea that the entire family should participate in childbirth and child rearing, as opposed to mothers working alone with doctors and nurses, this new kind of care meant that at Prentice fathers were for the first time allowed to be present during labor and delivery. Fathers also had extended visiting hours before and after the birth, and families had free access to their newborns. These modern practices were in sharp contrast to the then-standard procedures in which fathers were segregated in waiting rooms during the births, and babies were held in glass-walled nurseries until it was time for them to be taken home. The hospital’s promotional pamphlet boasted that “having a baby at Prentice is – as far as possible – a family event,” undertaken in an environment approximating the home. Standard post-delivery hospital stays were also to be drastically reduced, from five days to two or three in order to improve the hospital’s efficiency and to minimize disruption into family life. This revolutionary attitude towards childbearing required an equally revolutionary building, one that would emphasize community, comfort, and caring.At some point after the original commission, but before Goldberg arrived at the final design for the building, NMH requested that facilities be added to accommodate the Northwestern Institute of Psychiatry. In a 1971 cross-section of the building psychiatric uses are indicated for three of the seven floors of the bedtower, although eventually the Institute of Psychiatry was confined to the base portion of the building. (Image 6) The large flexible spaces there accommodated a wide variety of uses relating to the Institute, including offices, group therapy rooms and alcohol abuse clinics. (Image 8)The wide variety of activities to be undertaken at Prentice, the fact that each of them had highly specific mechanical and spatial requirements, and the lack of precedent for many of them in hospital design meant that the architect for the project would need to creatively design a single building that could simultaneously serve a number of different demanding purposes. Bertrand Goldberg’s outspoken belief that human interactions should shape the buildings that contain them, and his experience with complex high-density urban developments, made him well-suited for the difficult task of designing an innovative new health center.By the late 1960s, Goldberg was already a well-known architect in Chicago, having completed the iconic Marina City development on the north bank of the Chicago River. He had also shown proficiency with medical architecture at the Elgin State Hospital, northwest of the city. According to a June 2011 interview with Golbderg’s son, Geoffrey Goldberg, he had known Dr. Beatrice Tucker, the Chicago Maternity Center’s senior obstetrician, since at least 1960, when she asked him to design a prototype for a neighborhood birthing center that could be replicated in impoverished areas around the city. He provided those designs in 1962, although apparently nothing was ever built as a result. Dr. Tucker was not invited to participate in the planning of Prentice, but her forward-thinking ideas about women’s health, family life, and childbirth made a deep impression on Goldberg and guided many of his ideas for the project, including the basic premise that patients should be grouped in communities around a nursing center. His involvement with Dr. Tucker and his experience at Elgin likely played a role in NMH’s selection of BGA to design this new women’s health center in downtown Chicago.DesignOn July 11, 1973, Goldberg delivered a talk about his concept for the women’s hospital at a luncheon attended by major donors to NMH and members of Prentice’s staff. (Lecture notes accessed at the Goldberg Archive at the Ryerson Library) Goldberg described the new facility as a “point of entry to all medical care for women,” offering gynecology, birth, fertility treatments, abortions, and all of the medical research needed to develop these procedures. The new hospital was intended to revolutionize medicine for women by providing a less “isolated” environment than the doctor’s office, delivering ambulatory care without hospital stays, and offering surroundings that would improve patient relationships with caregivers. He outlined the architecture that would serve this program: four “villages” per floor, adjacent to nursing centers, each accommodating 12 to 14 beds each. Each of the floors would have a centralized support area. The base of the building would contain flexible space for other purposes besides patient bedrooms. The hospital would also include research facilities that would be coordinated with nursing areas. At the end of his speech, Goldberg’s notes indicate that he addressed the concrete shell construction of the building, which he described with one word: “landmark.”By the time of this talk in the summer of 1973, construction for the building was just getting underway, but BGA had already spent almost four years working on the project, not to mention Goldberg’s decade-long involvement with Dr. Tucker. Goldberg was also simultaneously working on three other hospital projects: Affiliated Hospitals in Boston, Massachusetts. the Health Sciences Center in Stony Brook, New York; and St. Joseph’s Hospital in Tacoma, Washington. All of these projects, as well as the handful of medical facilities he designed later in the 1970s, use a similar combination of curvaceous towers above rectilinear base structures. But at the beginning of the 1970s Goldberg was so far unsatisfied with his explorations into this concept. He believed that hospitals should have open and flexible space in order to accommodate a variety of different uses and the changes that would inevitably come in medical technology. The large floor plates of the round towers required columns or walls to support them, which penetrated the rectangular base structures below, interfering with their open plans. At Prentice he came up with a structural solution that finally satisfied his goals for medical architecture, and he felt it was the culmination of his investigation of hospitals. (Blum 223)In his planning for Prentice, Goldberg went through three different designs before arriving at the final design around 1971. Because he was simultaneously working on a number of other hospital projects, elements of these other buildings can be seen in these early designs. The first, from 1969, shows a drum-shaped, curtain-walled tower, raised on pilotis that descend through the middle of a one-story pavilion. (Image 1) The smooth cylindrical shape of the tower mimics that of his Elgin State Hospital in Illinois, from 1967. A second plan for Prentice eliminated the large rectangular base altogether, consolidating the building into a ring of concrete tubes standing on arched supports, connected by glass-enclosed hallways on the upper floors. (Image 2) A third design, the most similar to Prentice’s final appearance and dating to around 1970, shows a rectilinear glass-curtain-walled base of about four stories with a plaza on its roof. (Image 3) Sprouting from the middle of this plaza is a mechanical core surrounded by three or four concrete bedtowers. Each tower has a rippling shell punctured by paired columns of oval windows, and is supported by a thin stem of concrete. A rendering of this design ran in the article in the Chicago Daily News on April 23, 1970 that publicly announced the new hospital to Chicago, and BGA went so far as to construct a three-dimensional model of it. (Image 3) A version of this design also found its application at St. Joseph’s Hospital in Tacoma, Washington, completed in 1975. While the smaller towers in this early design for Prentice use similar cantilevers as the ones seen in Prentice’s final form, they are not as dramatic. The four stems and the mechanical core were all separate, and not yet consolidated into the single central support of the finished building. None of these early designs quite compare to the levels of flexibility and inventiveness that distinguish Prentice’s final form. The tower supports in all three cases significantly interfere with the flexibility of the base structure, or, as in the case of the second design, the base is altogether eliminated. Considering the diversity and changeability of the program requirements at Prentice, these designs would not have been as well suited to its intended uses. At the topping off celebration held at Prentice’s construction site on May 23, 1974, Goldberg said that this hospital was “designed from the inside out.” (Lecture notes accessed at the Goldberg Archive at the Ryerson Library) The building was intended to be a shell, protecting and surrounding the hospital activities within, but never interfering. Given NMH’s need for traditional, rectilinear, flexible space for administrative, office, operating, and labor rooms, Goldberg knew he had to provide a spacious rectangular base that could have its interior spaces infinitely reconfigured. The bedtower above would need to be physically connected by stairs and elevators in order to allow circulation between them. In order to avoid interrupting the base structure’s flexibility, the tower’s structural supports had to be consolidated with this connection as well. The entire tower had to somehow cantilever off of a single supporting core. Prentice was certainly not the first time Goldberg had considered monumental cantilevers as a design solution; even at Marina City he felt that the supporting columns of the towers interfered with the commercial spaces on the ground. A cantilever was considered there, but was determined to be too dangerous. (Goldberg interview, June 21, 2011)It was only with the help of brand-new computer technology that Goldberg was able to achieve a satisfactory structure at Prentice. The floor plates of the bed tower had to be so large, and the cantilever from the core so extensive, that the task of figuring out how to engineer the concrete shell and supporting intersecting arches became staggeringly complex. In the 1950s, designers (primarily in military and aeronautical fields) began using a method known as finite element analysis to engineer the increasingly complicated machines being developed in the mid-century industrial boom. This new approach allowed engineers to isolate individual structural elements and evaluate their behavior – a necessary tactic for Prentice’s complicated and untested new shape. Although Goldberg did not invent finite element analysis, it had probably never before been used on a structure as large or complex as Prentice. This was in part due to the fact that the high-speed digital technology necessary to analyze that many structural elements was not available. By the time Goldberg began work on Prentice, digital computers were still in their infancy, but BGA were the American architects at the vanguard of this technology. Goldberg and his chief structural engineer, Ludwig Stainer, worked with a sister company called Computer Service Incorporated and two engineers there, Mike Eiben and Mickey Gerardi, to retrofit finite element analysis software made by the Control Data company in Minneapolis. Although the program was normally used to design airplane wings, BGA and Computer Service Inc. managed to transform it into one of the world’s first three-dimensional modeling programs with an architectural application. (Image 9) This was an important achievement at a time when primitive technology made any kind of computer drawing, even in two dimensions, difficult. (Historical information about the design and engineering of Prentice is from an interview conducted with Goldberg’s son, Geoffrey Goldberg, on June 21, 2011.)With this essentially homemade software, Goldberg and Stainer were able to undertake previously unheard of amounts of engineering calculations in a matter of weeks. The result was a structural system at Prentice that had never been used anywhere else in the world. Both the lightweight concrete shell and the cantilever of the tower remain highly complex by present day engineering standards. Fixed element analysis and digital computing have since made possible an architectural revolution of convoluted shapes and sculpted structures by architects like Rem Koolhaas and Frank Gehry. The structure of Prentice also remains rare, and possibly unique. Few buildings in the world are supported by concrete shell walls as thin as Prentice’s. The combination of this shell with the unusual 48-foot cantilever makes Prentice’s structure a very unusual one.The curving cloverleaf-shaped exterior wall of the tower both circumscribed the clustered organization of the “care villages” within, and also formed a structural shell that transferred forces down to the sideways arches at the foot of the tower and from there to the elevator enclosure at its core. This meant a high level of flexibility in the floor plans of both the tower and the base below. This, in the end, was the ultimate goal of all of Goldberg’s technological work. In this way, Prentice is an excellent illustration of one of the key aspects of architectural Modernism: the use of new technology in service of more humane environments. Although the tower is the most striking feature of Prentice both aesthetically and structurally, Goldberg emphasized that the facility was not one, but two buildings: a tower as well as a base. (Goldberg topping off speech, May 23, 1974) The radical division between the two parts - enabled by the consolidation of the tower’s support structure at its core - allowed Goldberg to address NMH’s complex programmatic needs and his own desire for peaceful, secluded bedrooms for patients. All of the administrative, delivery, and various other support activities could be segregated in the base structure while the bedtower was devoted to rest and recuperation with family and nurses nearby.While the complicated engineering calculations necessary to construct Prentice’s revolutionary concrete tower were expedited by new computer technology, the design process was slowed by programmatic changes requested by NMH. Between the original instructions given to BGA in 1969 and the beginning of construction in 1972, the project went from being a hospital devoted entirely to the care, treatment, and study of women and babies to all of that plus a home for the Northwestern Institute of Psychiatry. However, since this and other major changes (including the addition of an eleventh-floor laboratory) were made prior to 1971 they were included in Goldberg’s renderings from that year, which show for the first time the building in its built form. (Image 6)