Postmodern hospitals normalize sickness with colourful elevators and hot-air balloons. It's a process that makes some critics queasy, but it puts patients at ease.

Strange things happen when life imitates work. About two weeks after the publication of my book, Medicine by Design — a study of early twentieth-century hospital architecture design — our 12-year-old son was unexpectedly hospitalized in the United States. There was no time for a book launch, or even much of a celebration, as his situation remained worrisome. The first night my husband and I slept head-to-feet in two chairs beside his bed, despite a one-parent-only regulation. We experienced the "normalization" of sickness first-hand, and the massive role architecture plays for hospitalized children and their parents.

Forced to sleep on my side, I can still remember the rhythmic breathing of the mother next to us in the ward, as her pregnant belly pressed against my back, separated only by a thin curtain. I never saw her face and then she was gone. The next night we vied for a spot in the parents’ lounge, a place I knew well from contemporary hospital plans. A young mother folding laundry in the lounge had been there for three months because her baby daughter had leukemia. When I told her I’d be going home soon, she nodded knowingly, “That’s what I said too.” We both cried. An elusive diagnosis for our son inspired a return to Canada for more medical care. Meanwhile, my academic papers on hospitals, written months earlier, continued to appear. It was an eerie sensation: I was living my research.

Hospitals are frightening places, even for experts. Since the 1980s, hospital architects have done their best to make kids’ hospitals look as un-hospital-like as possible in an attempt to quell our fear of serious illness. Giant atrium entrances, colourful decoration, and rooms big enough for two parents to stay with their child make many pediatric healthcare centres look like hotels and/or shopping malls. Toronto’s SickKids, with its eight-story, glass-roofed lobby and retail outlets, echoes the nearby Eaton Centre. The quick-moving yellow elevators and large tutu-clad pig crossing the space on a tightrope remind us of hotels and amusement parks. An extraordinary number of new children’s hospitals feature transportation gimmicks, a topic with scant connection to healthcare. The main stairway in Janeway Children's Health and Rehabilitation Centre in St. John’s, for example, is based on a ship. The St. Louis Children’s Hospital has a hot-air balloon that really ascends. What’s up?

Hospitals that look like malls and hotels and Disney parks are how we have come to “normalize” sickness. And in exceptional times such as during the SARS crisis of 2003, Toronto’s hospitals resembled airports.

Even for an aficionado like me, the hospital is an elusive place. Over the past fifteen years or so I’ve studied SickKids and a handful of Montreal hospitals as an academic researcher, professionally, systematically, objectively. In one project done with colleagues at the University of Toronto we gave young patients cameras and asked them to document the atrium at SickKids. The children produced beautiful images. We analyzed and exhibited them. We linked the design of SickKids to postmodern theory, in its allusions to malls and amusement parks, in its celebration of the ordinary, in its pretense to be outside and inside at once. We thought we understood.

We learned much from the sick kids at SickKids. Not surprisingly, their words and images emphasized anxieties around containment and entrapment. They longed to go outside. Many noted how they saw other kids who looked frighteningly sick in the atrium and in turn, how they were seen by others and felt embarrassed. One boy even wrote a poem about how the atrium kept him company. In general the project showed us the sophistication of children’s responses to architecture. Postmodern kids understand postmodern places. “It kind of gets you like, welcomed,” said one boy in describing the function of the atrium.

I remain hopeful that when life and work intersect unexpectedly, even in an emergency, both spheres benefit. Our son is much better, thankfully, and I still relish the thought of moving beyond hospital research, to happier buildings. At other times, I feel sure that I need to continue to understand the hospital in order to make it better. In any case, I'm more convinced than ever that hospital architecture is not just a stage -- that it plays a more crucial role in our medical dramas.