A Place to Recover

Last week, a friend was admitted with an infection to the London hospital where I trained as a medical student and now work. So, at the end of my operating list on Wednesday, instead of cycling straight home, I walked out of the annexe where I’d been doing my surgery and crossed the road to visit her in the main hospital. After decades away, returning somewhere that holds so many of my formative medical memories still feels a bit weird. But on that morning, I didn’t notice my emotional so much as my physical landscape, and in particular the awful architectural changes that had been wreaked on the place I used to think of as a second home.

The impressive porticoed entrance was still there. But gone was the spacious main atrium with its lofty arches, and the roomy central corridor which served as the main artery from which all the other clinical tributaries ran. The hospital of my memory might have been grotty but it was grand. As I reached the end of the boxy corridor and took the stairs up to the second floor, my heart sank at how hemmed in the space now felt, its previously cavernous ceilings panelled into a hygienic but claustrophobic warren of tunnels.

Things only got worse when I stepped onto the ward. Two decades ago, the high density of colorectal patients had earned this spot a reputation for being malodorous. But what was this fresh hell? Noisy as a traffic jam and suffocatingly hot, the tall Victorian windows which had once let in light and air were nowhere to be seen, probably hidden behind the featureless, wipe-clean walls. I found my friend curled up on her side in bed looking forlorn, in a dim stuffy bay occupied by 5 other women. Her eyes were closed and who could blame her?

In 2000, the year I became a doctor, an ambitious programme called Enhancing the Healing Environment was launched in response to widespread concern among NHS leaders that the decrepit state of hospitals was actively obstructing patients’ recovery. Attracting more than £2.25 million from The King’s Fund, all 48 London hospitals participated. Tangible results, including the discovery that improving the clinical habitat enhanced both patient recovery and staff morale, led to recommendations being extended well beyond acute hospitals, into community settings and the prison estate.

Yet where are we now? In October 2025, NHS England estimated that it would cost £16 billion simply to restore hospital buildings to basic function. A quarter of patients these days have to wait up to 12 hours before they’re moved onto a hospital ward. And when they get there, the best a seriously sick person can look forward to is a bed in a room like the one I found my friend in, where constant noise, fluorescent lighting and lack of privacy are de rigueur, despite these conditions having been shown to obstruct recovery.

Sitting at my friend’s bedside waiting for her to wake up, I found myself remembering an exhibition I saw years ago at The Wellcome Collection, all about healing architecture. I still recall Finnish architect Alvar Aalto’s 1930s tuberculosis sanatorium, which he built in Paimio Finland. With its jewel-coloured interiors, ergonomic furniture and abundant light, this hospital amazed me as a kind of exemplar of what a therapeutic space might be. A century later, our patients can only dream of such a place.

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My friend opened her eyes and soon felt strong enough to sit up and share the sandwiches I’d brought from the hospital’s M&S foodstore - praise be to this small mercy at least! Under the flickering strip lights, in the oppressive summer heat, with no view of the sky, we munched away, as the patient on the other side of the thin curtain protested to a doctor that no, she didn’t want a sedative to help her sleep that night, all she needed was for the ward to be dark and quiet.

Aalto’s TB sanatorium might feel like reaching for the stars. But it’s surely not asking too much that our patients be welcomed in a timely fashion onto wards where they can heal in quiet, temperate, surroundings with access to daylight and dignity. This should be the minimum provision of any hospital setting. For at no time do we crave external peace more than when our insides are failing. At no point are we more in need of harbour, than when disease and trauma lay siege to our body, our most intimate home.