How hospitals became today's cathedrals

The rise of "destination wellness centers," like Swedish's lavish new hospital in Issaquah, makes one despair of, among other things, ever getting health-care costs under control.

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Swedish/Issaquah Hospital: a destination wellness center.

The rise of "destination wellness centers," like Swedish's lavish new hospital in Issaquah, makes one despair of, among other things, ever getting health-care costs under control.

Theologian Stanley Hauerwas argues that it is possible to assess where a society places its trust by observing which of its buildings are the most imposing and impressive.

I recalled this observation as I read about the new $365 million Swedish/Issaquah hospital (check that: “Wellness Center”), which comes complete with five-story atrium, shopping mall, spa, and destination restaurant. Swedish executive Kevin Brown was quoted as saying, “It’s not your father’s hospital.”

The article, which described both regional and national trends in hospital and medical center design and construction, indicated that many of the newer facilities were “less fortress and more community center.” One wonders what it says about a society if a hospital or health care facility is not only its most imposing building but also thought to be the “community center?”

If theologian Hauerwas is right, it means that these days we are placing our bets on health care and medical centers to save us. Which is one of the reasons that health care “reform” or not, we are unlikely to get our health-care costs under control.

Hauerwas points out that in the Middle Ages, and really for most of human history, the predominant buildings were religious: Notre Dame Cathedral. St. Peter’s Basilica, the Masjid al Haram Mosque in Mecca, the Great Temple in Jerusalem. In the 19th center the industrial plant or factory began to compete with temples and shrines. Sometime in the mid-twentieth century the huge skyscapers and monolithic office complexes symbolized our trust in human technology and economic progress.

Today? The most impressive “cathedrals” are our enormous medical centers. St. James’ Cathedral on Capital Hill is dwarfed by its neighbor, Swedish Hospital.

Certainly the amenities of the new “destination wellness centers,” including greater use of natural light, individual rooms to reduce risk of infection, first class restaurants and shops, not to mention millions spent on the latest in medical technology and devices, have their benefits and appeal. But what does it say about a society when these are our largest and most imposing structures?

Perhaps this, that we doubt there is really anything other than or beyond this life and we’d better prolong as long and with as much help as we possibly can. Such is the diminished faith of 21st century modern culture that we look to medical centers for our hope and salvation.

There are of course other concerns. Who exactly will get into these lavish new facilities for treatment? Hospitals are apparently in heavy competition for health-care consumers (no longer “patients”) and particularly the well-insured ones. Is this really a good plan, a great system, competing for the health-care buyer with the greatest buying power? Doesn’t it exacerbate our already amazing capacity for denying death and mortality, and also privilege the most affluent?

For my work I do a good bit of traveling. In one stretch last fall I found myself in a string of mid-size cities including Allentown, PA, Dayton, Ohio, Kalamazoo, Michigan, and Syracuse, New York. In every one of these cities and others the economy was in a shambles. Downtowns were on life-support. Empty offices and plants were everywhere.

But in each city the one point of civic pride was the “medical center.” I would be driven by as my guide told me of the “best-in-the-world doctors and facilities” here in Dayton or Kalamazoo. “People,” they would intone, “come from miles around.” I thought of the pilgrimages of an earlier era to Lourdes. Now we make our pilgrimage to the Mayo Clinic.

After half a dozen such experiences, I became a skeptic about ever containing health care costs. After all, these facilities are not only a point of civic pride and nearly religious devotion; in most of these towns they appeared to be the most viable part of the economy.

“It’s not your father’s hospital,” as the Swedish executive about Swedish/Issaquah, and I’m sure that’s true. Still, the advent of the destination hospital, and of the medical center qua community center, makes me long for society where health care wasn’t the center of our lives.


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About the Authors & Contributors

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Anthony B. Robinson

Anthony B. Robinson was the Senior Minister of Plymouth Church in downtown Seattle from 1990 to 2004. He was also a member of the Plymouth Housing Group Board. After living for many years in southeast Seattle, he moved recently to Ballard.