So today I was treated to a lecture by a McGill architecture prof on the history of Montréal hospitals, with a focus on the Royal Victoria Hospital as an interesting perspective on local social history. Among several key themes, the idea of a personal and societal connexion to a particular hospital arose, with the Vic serving as an even better case study on some of the cultural and ethical considerations to make when proposing radical modernization of institutions. As we ought to know, the Vic, along with the Montreal Children’s, a sizable chunk of the General and the Montreal Chest Institute will all be folded into the new MUHC Superhospital currently being excavated at the site of the former Glen Yard, near Vendome Métro.

If you’ve been reading the news for the last twenty years, you no doubt have a vague, intrinsically hostile reaction to the mere mention of the new compound word superhospital; it’s a seemingly endless quagmire of incompetence, delays and, compounding it all, that eerie sixth-sense tingling at the back of your spine nagging as to its fundamental necessity. Unfortunately for those of us not yet completely numbed to the inertia of the Québec government (in any form), we’ve been left to go back and look over the evidence, and its pretty damning. Worse still is that the superhospital project has finally broken ground – literally. They’re excavating about five floors worth of highly contaminated soil to eventually build a 2,500 car capacity parking garage – right at the corner of one of the busiest intersections in the entire country. Atop this vehicular birdhouse will sit the hospital digitally rendered above; easily twenty years behind schedule, both new superhospitals have entered the preliminary stages of construction – that is to say, the demolition, excavation component. I encourage all of you to go see the mesmerizing sight of roughly ten construction towers looming over a massive floodlit pit – it’s truly breath-taking. The problem here is that the MUHC Superhospital is gearing up to be yet another white elephant in a city which has too many as is. Given that the buildings are in such an early stage of development, I think a new round of public debate needs to occur to make sure this project doesn’t become a complete disaster.

Here’s a short list of what’s going wrong. We’ve already covered the toxic soil – a result of the site’s former occupation as a freight railyard, pictured here:

And the fact that it’s located in the worst possible location, adjacent to the Turcot Interchange – which is due for a major renovation. And that they still haven’t factored in connecting this damned hospital to the Vendome Intermodal station (which is beyond incompetence – it seems clear to me that this omission was on purpose so that a contractor could benefit from an inflated price (estimated at $30 million to build a tunnel under the railway).

So on top of these scandals, and that the project is retarded to the tune of twenty years, it also won’t be able to accommodate the number of beds available in the hospitals it will replace – about 800 for the new hospital compared with about 1200 spread out through the current MUHC system. Read all about that here.

And then there are the common sense issues, like why anyone would build one big hospital when the city and province have already had considerable problems containing hospital based disease, such as C. difficile. Then there are the practical considerations: communities require hospitals, and hospitals build and maintain communities. Institutional memory and public reverence for institutions build character and solidify the social solidarity. It builds community consciousness and civic proprietorship. Building a white elephant superhospital, which is what this plan is shaping up to be, will not only result in cost overruns and traffic jams, it may also result in the hospital’s public losing faith in the institution. I don’t think Montréal Anglophones have much left to lose faith in – can we afford to lose important hospitals for the sake of modernization and efficiency?

That last point is another bone of contention. While the argument that a superhospital will save money because expensive equipment can be shared, the idea that the superhospital will be in any architectural or societal fashion ‘modern’ is blatantly false. This hospital was designed and conceived of in the 1980s. And it has been such an ordeal just to get to the point of breaking ground no one has given much thought to finding a more suitable location (ideally, closer to the city and university it is affiliated with and away from a traffic logjam) or what impact the hospital closings may have on the population it is intended to serve.

Among the hospitals slated for closing, the Royal Victoria Hospital is perhaps the most iconic and established amongst Montreal’s anglophone population; a building with far too many memories to be demolished. It has been expanded several times since it opened in 1893, and carries a caveat attached to the donated land and buildings – they can only ever be used for education and healing. A very old woman in Westmount is committed to making sure the wishes of Lord Strathcona & Mount Royal and Lord Mount Stephen are carried out, if it’s the last thing she ever does.

There has been speculation that the Vic may simply be absorbed into McGill University, which could greatly expand its medical school and potentially convert some buildings into student dormitories – an almost ideal evolution of the built environment at the corner of Pine and University.

But what of the Children’s?

If there was ever a hospital population to be segregated from the general population, it is undeniably children. Sick kids require a special environment, one ideally sealed from adult diseases, pain and suffering. A children’s hospital ought to foster the notion of recuperation, rehabilitation and optimism. I always thought the pediatric hospital and the birthing hospital should be in the same place – I can think of no other kind of hospital where the demand for a miracle be as high as in a children’s hospital, and can think of no better provider of miracles than a maternity ward. Our Children’s should be kept where it is – as it stands now it is an anchor of the Atwater/Shaughnessy Village area, and that area has already suffered the loss of the Reddy Women’s Hospital some years ago.

As for the General, it is unclear as to exactly what will happen here; since it will remain a level-1 trauma center and has a significant amount of space, it seems likely that it will be used to handle ‘overflow’, though how this will work is unclear to me. At the end of the day, the MUHC Superhospital is looking more and more like a highly specialized jack-of-all-trades teaching hospital. High specialization. Concentration. Education. Those are a lot of hats to wear simultaneously, and like anything else that tries to hard to be too many things to too many people, it will likely fail at its intended purpose. The Superhospital is probably going to be looked on as a super mistake, and the taxpayers will be left with a supersized bill. Once the project reaches the state of public derision and ridicule, much like the Olympic Stadium or Mirabel International, it will be seen pessimistically as little more than yet another recent failure of a once proud and successful people. Can we afford such malaise?