The Program

Eleven Rooms

Chapter 3: The Program

The architectural program is the document that exists before the design. It is not the design. It is the statement of what the design must accomplish, the list of requirements that the building must satisfy, the written record of need that precedes the drawn record of response. Miriam had written ten architectural programs for ten hospice buildings over twenty-two years, and each program had begun the same way: with a room count and a list of functions and a set of adjacency requirements that described which spaces needed to be near which other spaces and why, and each program had ended the same way: with the acknowledgment, implicit in the document's structure, that a building is not a collection of rooms but a system of relationships, and the relationships are the architecture, the rooms are merely the evidence.

She sat at the desk her father had built. David Chen had built the desk in 1998, when Miriam had opened her own practice after six years at a firm in Seattle where she had designed medical offices and dental clinics and one urgent care facility that had taught her nothing about architecture and everything about fluorescent lighting, which is that fluorescent lighting is the enemy of human dignity, a fact she carried with her into every subsequent project and that had resulted in a personal prohibition against fluorescent fixtures in any building she designed, a prohibition her clients sometimes questioned and she never explained beyond saying: the quality of light is the quality of the space, and I will not design a space with bad light, which was the kind of statement that either convinced a client of her seriousness or convinced a client to hire a different architect, and either outcome was acceptable because Miriam did not want clients who did not understand that light matters.

The desk was white oak. Six feet long, thirty inches deep, thirty inches high. David had built it with the precision of a civil engineer, which he was, and the care of a father, which he also was, and the combination of precision and care had produced a desk that was both structurally sound and emotionally present, a desk that carried the knowledge of its making in every joint, every surface, every edge that David had hand-planed and hand-sanded until the wood was smooth the way water is smooth -- not flat, not featureless, but continuous, uninterrupted, a surface the hand could travel across without encountering anything that stopped the traveling.

On this desk Miriam spread a clean sheet of paper -- not trace paper, not the translucent medium of design, but white bond, opaque, the paper of documents, of statements, of the written word that precedes the drawn line -- and she uncapped a different pen, a blue pen, a pen for writing rather than drawing, because the program is written, not drawn, and the distinction mattered to Miriam the way all distinctions between media mattered, the way the difference between cork and tile mattered, the way the difference between low-iron glass and standard glass mattered, the way the difference between a thirty-two-inch door and a thirty-six-inch door mattered -- not as aesthetic preference but as professional conviction, the conviction that materials are not interchangeable, that each material carries its own meaning, and that the meaning of opaque white bond paper is declaration while the meaning of translucent trace paper is exploration, and the program is a declaration, not an exploration, though the declaration will enable the exploration that follows.

She wrote at the top of the page: ORCHARD HOUSE HOSPICE -- ARCHITECTURAL PROGRAM.

Below that: Bend, Oregon. Deschutes County. Five acres. Former orchard land.

Below that: Architect of record: Miriam Chen, AIA. Chen Hospice Architecture, Portland, Oregon.

Below that she began the list.

Patient rooms: sixteen.

Each patient room two hundred and forty square feet. Private bathroom. East or south exposure. Operable window. Space for two visitor chairs, one recliner, medical equipment. Clearance: minimum four feet on all sides of bed. Ceiling height: minimum nine feet six inches. Floor: cork. Walls: acoustic plaster over sound-attenuating substrate. Door width: thirty-six inches minimum. Hydraulic door closers. Natural light: minimum sixty square feet of glazing per room. Artificial light: dimmable, warm-spectrum LED, no fluorescent. Oxygen and suction at head of bed. Nurse call at bed and in bathroom. No overhead paging -- visual notification only, because the sound of a public address system is the sound of an institution, and a hospice should not sound like an institution, should sound like a house, should sound like the quiet of a house where someone is resting, someone is ill, someone is being cared for in the private quiet of domestic space, not the performative urgency of clinical space.

She had arrived at these specifications through twenty-two years of revision. The first program, for Sage Hill in 2004, had specified patient rooms of one hundred and eighty square feet, which she had discovered was too small -- too small for the family that gathers, too small for the grief that needs room, too small for the dying that deserves space. The third program, for Cedar Creek in 2009, had specified two hundred and twenty square feet, which was better but still insufficient when three or four family members were present, which they often were, because dying draws families together the way gravity draws matter together, inevitably, irresistibly, each family member pulled toward the center by the force of the ending, and the room must accommodate the drawing-together without compression, without the feeling that the walls are too close, that the space is insufficient for the weight of what is happening inside it.

By the seventh program, for Evergreen House in 2019, she had settled on two hundred and forty square feet as the dimension that balanced the patient's need for intimacy -- a room too large feels impersonal, feels institutional, feels like a space designed for a function rather than a person -- with the family's need for presence, the need to be in the room, to sit beside the bed, to stand by the window, to pace the three steps between the door and the chair that is the pacing of the anxious and the grieving, the small repetitive movement that the body performs when the mind cannot rest.

Two hundred and forty square feet. She wrote it again. She had written it in four previous programs and she wrote it again because the program is not a copy of previous programs, the program is a fresh declaration for a fresh building, and each fresh declaration must be arrived at through the fresh application of the architect's accumulated knowledge, which includes the knowledge that two hundred and forty square feet is the right size for a dying room and also includes the knowledge that the right size is not a permanent fact but a professional judgment, a judgment that could change if the architect's understanding changed, and the act of writing the number again was the act of confirming the judgment, of testing it against the current understanding, of asking: is this still true? Is two hundred and forty square feet still the space the dying need?

It was still true. She moved on.

Family overnight rooms: eight. One for every two patient rooms. One hundred and sixty square feet each. Within earshot of the patient rooms they served but separated by a corridor, a turn, a door -- the separation sufficient to allow sleep, the proximity sufficient to allow presence, the balance between sleep and presence being the fundamental challenge of hospice design for families, because families need to sleep and families need to be near and the two needs are in tension and the architecture must hold the tension without resolving it, must provide both the quiet room for sleeping and the short walk to the bedside, must make the short walk short enough that a family member can travel it in bare feet at 3 a.m. without feeling that they have left, that they have gone somewhere else, that the distance between the sleeping room and the dying room is a distance that matters.

She had learned this at Cedar Creek, where the family rooms had been on a different floor from the patient rooms, connected by an elevator that was slow and by stairs that were cold and by a corridor that was long and lit with the institutional lighting she had not yet learned to prohibit, and families had complained, had said: we feel far away, we feel separate, we feel as though our person is somewhere else and we are somewhere else and the somewhere else is too far, and Miriam had understood that the complaint was not about distance in feet but about distance in feeling, about the architectural failure to create the sensation of nearness that families need when their person is dying, the sensation that the dying person and the family are in the same place, the same building, the same house, even if they are in different rooms, and the creation of that sensation is a matter of adjacency and of the quality of the passage between the rooms -- the corridor, the door, the turn, the materials underfoot, the light in the corridor at 3 a.m. -- and the quality of the passage is as important as the quality of the rooms themselves.

Common area: one. Eight hundred square feet. Open to the corridor. Furnished with residential furniture -- sofas, armchairs, lamps, bookshelves -- not the institutional seating of a hospital waiting room, not the rows of identical chairs facing a television, but the varied, comfortable, imperfect furniture of a home, furniture that says: sit here, rest, be human, be a person who is waiting and afraid and tired and in need of a place that does not feel like a place of waiting but feels like a place of being.

Kitchen: one. Six hundred square feet. Open to the common area. Residential equipment -- a range, not a steam table; an oven, not a warmer; a refrigerator with a glass door so the food is visible, because visibility is availability and availability is welcome and welcome is what a kitchen offers, the welcome of food, the welcome of the smell of food, the welcome that does not ask whether you are hungry but simply presents the possibility of eating, which is the possibility of living, which is a possibility that must remain present in a hospice even as the certainty of dying is also present, because the two are not opposed, living and dying, they are concurrent, they happen in the same building, in the same rooms, in the same bodies, and the kitchen is the room that holds the living.

Miriam wrote the kitchen specifications with the care she gave to all specifications but with an additional attention that she did not give to the patient rooms, because the kitchen was the space she had struggled with most in her career, the space that most resisted the institutional pressures that shaped hospice design. Boards of directors wanted cafeterias. Health inspectors wanted commercial kitchens with stainless steel surfaces and three-compartment sinks and the sterile efficiency of food service rather than the warm inefficiency of cooking. Insurance companies wanted food prepared off-site and delivered in sealed containers, because sealed containers reduce liability the way sealed buildings reduce weather, by keeping the outside out, by maintaining control, by eliminating the variables that make cooking -- like living, like dying -- unpredictable and human and real.

Miriam fought for the kitchen every time. She fought for the range and the oven and the wooden cutting boards and the open shelves and the smell of cooking that traveled from the kitchen through the common area and down the corridor and into the patient rooms where the dying lay in their beds and smelled food, smelled garlic and onion and bread and soup and the accumulated domestic smell of a kitchen that was being used the way kitchens are used in homes, not efficiently but lovingly, not to produce food but to produce the experience of food, which is the experience of home, which is the experience that every hospice must provide or fail in its fundamental purpose.

She wrote: No cafeteria. No steam table. No sealed food delivery. Kitchen staff to prepare meals on-site. Patients eat what they want, when they want. Menu changes daily based on patient preference and seasonal availability. Kitchen visible from common area and corridor. Smell of cooking unrestricted.

That last specification -- smell of cooking unrestricted -- was the one that provoked the most resistance from facility managers and infection control consultants, who viewed the uncontrolled movement of cooking smells through a healthcare facility as a vector for something, though they could never specify what, exactly, the smell of bread baking was a vector for, except perhaps the feeling of being alive, which is not a condition that infection control protocols are designed to address.

Garden atrium: one. Central to the building. All corridors lead to it. All patient rooms look onto it. Open to the sky -- no roof, or a partial roof, depending on the climate analysis, which in Bend, Oregon, where the annual snowfall averaged thirty-three inches and the winter temperatures dropped below freezing on one hundred and fifty nights per year, would require a partial enclosure, a roof of glass or translucent panels that admitted light while excluding snow, that created an interior space with exterior qualities, a space that was both inside and outside, both building and garden, both architecture and nature, and the both-ness was the point, the both-ness was the thing Miriam was designing toward.

She wrote: Apple trees. From original orchard rootstock if available. Consult with local nursery re: heritage varieties compatible with Bend climate. Water feature: rill, not fountain. Narrow channel, six inches wide, recirculating, the sound of moving water at a volume that is audible from three feet and inaudible from ten, because the sound of water is the sound of persistence, the sound of something that continues, that moves, that does not stop, and the dying should hear persistence if they choose to hear it and should be able to not-hear it if they choose not to, and the choice is the thing, the architectural provision of choice being the fundamental dignity that a hospice building offers to people who have had most choices taken from them by the diagnosis.

Meditation room: one. Two hundred square feet. No windows. No furniture except floor cushions and a single bench. The only room in the building with no windows, the only room that does not participate in Miriam's campaign for natural light, because the meditation room was the room for the interior, the room for the person who needed not the world but the absence of the world, the room for the family member who had sat beside the bed for twelve hours and needed a space without the bed, without the window, without the view, without the light, without anything except silence and enclosure, the architectural equivalent of closing one's eyes, and Miriam provided this room in every building because she understood that the need for the world and the need for the absence of the world are both legitimate needs and the building must serve both.

Staff spaces: offices, break room, supply storage, laundry. Seven hundred square feet total. Adequate but not generous, because the building was for the patients and the families and the staff spaces existed in service of the patient spaces and must not compete with them for square footage or for light or for the quality of finish that Miriam applied to every surface the dying would see. But -- and this was a correction she had made after Sage Hill, where the staff break room had been a windowless closet with a folding table and two plastic chairs -- the staff spaces must be dignified too, must acknowledge that the people who worked in a hospice worked in the daily presence of dying and that the daily presence of dying required a break room with a window and a table made of wood and chairs that were comfortable and a coffee maker that was good, because the quality of the coffee maker in the break room was a measure of the institution's respect for its staff, and Miriam measured respect in material terms because material terms were the architect's terms, the only terms she trusted.

She wrote for four hours. The program grew to eighteen pages. It specified room counts and square footages and adjacency requirements and material standards and mechanical systems and the kind of light fixtures and the kind of doorknobs and the kind of flooring transitions and the clearance under the bathroom sinks and the height of the toilet seats and the angle of the grab bars and the shape of the nurse's station and the width of the corridors and the radius of the corridor turns, because a bed on a gurney requires a turning radius and the turning radius determines the corridor geometry and the corridor geometry determines the building geometry and the building geometry determines the relationship between the building and the site and the relationship between the building and the site determines the relationship between the dying person and the mountain view, which is to say that the turning radius of a gurney in a corridor is connected, through a chain of architectural decisions, to the last thing a dying person sees, and the architect must hold the entire chain in mind, must understand that every specification in the program is connected to every other specification, that the document is not a list but a system, that the system is the building, and the building is the system, and the architect's job is to write the system in language before drawing it in lines.

At two o'clock she stopped writing and she looked at the program and she saw, in the eighteen pages, the ghost of every previous program she had written, the accumulated revisions of twenty-two years, the changes made after each building taught her what the previous building had not known, and she saw also the ghost of her mother, present not in the text but in the space around the text, in the margins, in the white space that surrounded the words the way the garden would surround the building, the way the light would surround the rooms, the way the dying is surrounded by the living.

She had not written her mother into the program. She had not specified anything for Orchard House that she would not have specified if her mother were not dying in Room 6 of Evergreen House at this very moment, lying in the bed Miriam had specified seven years ago, looking at the window Miriam had designed seven years ago, breathing the air that the mechanical system Miriam had engineered seven years ago was conditioning to seventy-two degrees and forty-five percent relative humidity, the air that moved through the room at a velocity of twenty-five feet per minute, which was slow enough to be imperceptible and fast enough to prevent stagnation, the air that carried the smell of the cork floor and the acoustic plaster walls and whatever Nurse Thea was heating in the kitchen down the corridor, the kitchen Miriam had designed with the open plan and the residential range and the oven that baked bread on Tuesdays and Thursdays, the bread whose smell traveled down the corridor and into Room 6 and into Lin's awareness, and Lin would smell the bread and the smelling would be a moment of living inside the dying, a moment made possible by the kitchen Miriam had designed, and Miriam knew this, sitting at the desk her father had built, writing the program for the eleventh kitchen in the eleventh hospice, and the knowing was both professional satisfaction and personal anguish, braided together the way the strands of a rope are braided, each strand distinct but the rope singular, the rope the thing that holds, that bears weight, that connects one point to another across a distance that would otherwise be uncrossable.

She picked up the blue pen again. She added one more item to the program, an item she had not included in any previous program:

Room 11: patient room. Two hundred and sixty square feet. Twenty square feet larger than standard. East and south exposure -- dual-aspect glazing. Ceiling height: ten feet. Enhanced natural light. Rationale: the eleventh room in the eleventh building. The architect's prerogative.

She looked at what she had written. She did not understand it, not fully. She understood the dimensions and the specifications and the rationale she had provided, which was not a rationale but a statement, a declaration that Room 11 would be different, would be more, would be the room that exceeded the program's own standards, the room that was not just adequate but aspirational. She did not understand why she had written it. She did not connect it, consciously, to her mother or to Room 6 or to the fact that eleven was the number of her career's buildings and the number that would define this building and the number that carried, for reasons she could not articulate and did not try to articulate, a weight that exceeded its arithmetic value.

She capped the pen. She stacked the pages. She placed them in the folder she would bring to the meeting with James next week, the meeting where they would review the program together, where James would ask practical questions -- about the turning radius, about the mechanical systems, about the structural implications of a ten-foot ceiling in Room 11 when the standard ceiling height was nine feet six inches -- and Miriam would answer the practical questions with practical answers, and neither of them would discuss the room's number or its significance, because the significance was not practical, was not structural, was not architectural in the way that architecture is usually understood, but was architectural in the way that Miriam understood architecture, which was as the art of holding, the art of making rooms that hold people and their dying and their grief and their love and the light that comes through the windows in the morning, which is the light of continuation, the light that says: the world is still here, the world will still be here tomorrow, and the room will hold you while the world continues, and the holding is the thing, the holding is the architecture, the holding is what the program describes in eighteen pages of specifications and room counts and material standards and adjacency requirements, eighteen pages that are, in the end, eighteen pages about holding.

She turned off the desk lamp. She looked at the desk her father had built, the white oak surface, the hand-planed edges, the joints that David had cut with the same precision he had brought to the civil engineering projects that had been his career -- the bridges, the road grades, the drainage systems, the infrastructure of public life that David had engineered for forty years with the steady competence of a man who understood that the world was a physical system and that physical systems required physical solutions and that the physical solutions, properly engineered, would hold. David's desk held. It had held for twenty-six years. It held the trace paper and the programs and the pens and the rolled drawings and the coffee cups and the weight of Miriam's forearms when she leaned on it during the long hours of designing, and it would hold for twenty-six more years, for longer, for as long as oak holds, which is longer than a career, longer than a life, longer than a marriage, even a marriage of fifty-four years, even a marriage that had held through the raising of a daughter and the building of a desk and the retirement and the diagnosis and the afternoons in Room 6 where David sat beside Lin and read aloud from books she had requested, his voice steady, his hands shaking, the reading a form of holding that required no architectural program, no specifications, no drawings, only the voice, only the presence, only the being-there that was the simplest form of the thing Miriam spent her career designing the space for.

She left the office. She drove to Evergreen House. It was a twenty-minute drive from her office on Southeast Division Street to the hospice on Northeast Glisan, a drive she had made many times during the construction of Evergreen House seven years ago and that she now made for different reasons, the professional drive having been replaced by the personal drive, the architect's drive having been replaced by the daughter's drive, the drive to see the building having been replaced by the drive to see the woman in the building, and the replacement was complete, the building no longer the destination but the container of the destination, the architecture no longer the purpose but the context of the purpose, and the shift from purpose to context was the shift that Miriam's career had been building toward without her knowledge, the shift from designing rooms to inhabiting them, from drawing the space to grieving in the space, from the professional distance that had allowed her to design ten buildings for the dying to the personal proximity that now required her to live inside the eleventh.

She parked. She walked the level approach. She opened the double doors. She signed the visitor's log. She walked the twelve-foot corridor. She pushed open the thirty-six-inch door.

"You're back," Lin said.

"I brought the Sei Shonagon."

"Excellent. Put it on the table. I'll read it tomorrow. Today I want to hear about your program."

"My program?"

"The architectural program. For the new hospice. You were writing it today."

"How did you know?"

"Because I know you, Miriam. You visit the site, then you write the program. You've done it ten times. I've watched you do it ten times. I've watched you come home from a site visit and sit at that desk your father built and write for hours, writing down what the building needs to do before you draw what the building needs to be. I've watched you for twenty-two years. I catalogued you, Miriam. I catalogued you the way I catalogued everything: carefully, systematically, with attention to the primary entry and the cross-references and the subject headings that connect one thing to another."

Miriam sat in the chair. The visitor's chair. The warm gray fabric.

"Tell me about the program," Lin said.

So Miriam told her. She told her about the sixteen patient rooms and the eight family rooms and the kitchen and the garden and the meditation room and the corridors and the staff spaces and the material specifications and the light requirements, and Lin listened the way Lin listened to everything, with the focused attention of a professional cataloguer, a person whose life's work had been the reception and organization of information, and when Miriam finished, Lin said: "And Room 11?"

Miriam looked at her mother. "How did you know about Room 11?"

"I didn't know. I guessed. You're building your eleventh building. You would make the eleventh room special. You can't help it. You're an architect. You make meaning with space. The eleventh room in the eleventh building has meaning, whether you intended the meaning or not, and I suspect you did intend it, though you would not use the word meaning, you would use the word specification or perhaps enhanced design parameters, because architects do not admit to meaning the way librarians do not admit to reading on the job, though we do, we always do, we read everything, we cannot help it, the books are there and we are there and the being-there-together is the meaning."

Miriam held her mother's hand. The hand was thin. The bones were close.

"It's twenty square feet larger," Miriam said. "East and south light. Higher ceiling."

"Good," Lin said. "Good room."