White Coat Underground

Hospital city

I don’t have a lot of experience with small hospitals. My medical school’s hospital was about two square blocks of buildings, all of them attached, ranging in age from 100 years to 10 years. The were connected by irregular bridges and linked (ex)-fire escapes, and by miles of dim tunnels.

During my residency, the campus covered several square blocks, with buildings linked by more airy bridges (a la Minneapolis) and “secret” tunnels that you could find if you just knew where to look—although getting lost underground was the rule.

My current hospital is—by number of admissions—one of the largest in the country. It’s fairly modern, with the buildings ranging from 50 year old to three years old. But it has that sine qua non of all hospitals—a basement city.

My hospital is actually quite beautiful. There are occasional hints of the complexity hidden above and below—signal boosters jut from drop ceilings, oxygen hook-ups slide out from behind panels—but really, it might be confused for any hotel or office building. Until you climb into the basement.


Hospital basements are not unlike what you see on TV shows about aircraft carriers—remarkably complicated and busy. Wide hallways—roads, really—on which electric trucks pull carts full of supplies and garbage; break rooms carved out of back hallways with tables and vending machines; and of course, a radiation oncology department, with impossibly nice furniture.

Looking up at the maze of pipes, I see, clearly labeled, medical oxygen, medical vacuum, hot water, cold water, waste water, and many more. And of course, running like a hamster highway above, the tube system.

Tube systems are a Victorian holdover that the older of my readers may remember from downtown department stores (and still from time to time at bank drive-throughs). A pneumatic tube several inches in diameter sits at the nursing station, attached to an electronic switchbox. One can draw blood, place it in a plastic tube, dial in the lab, and *poof* it is sucked into the tube and delivered to its destination.

In the basement, the tube system is revealed to be, at least in its midsection, a pastafied network of large tubes with whisting and sliding sounds surrounding them—like I said, very Victorian.

Then of course there is room HM—the morgue. This bland metal fire door looks like any other basement closet, except for the men in suits with small uncomfortable-looking gurneys who seem to sprout up from time to time.

I love the basement, that underground city feel. You never know what time it is—noon, midnight—but that city is moving. Trucks are delivering gloves, cooks are preparing meals, tubes are whistling overhead. It is (despite room HM) very much alive, and in a place with so much illness and suffering, alive is a nice break.

Comments

  1. #1 Blake Stacey
    January 24, 2009

    In a weird way, your hospital basement reminds me of both the back half of the Huntsville Times facility (where my father worked when I was a young’un) and the zeroth floor of MIT. Neither of those locations have a morgue, however, to the best of my knowledge.

    OK, dumb question: why is radiation oncology in the basement?

  2. #2 Orac
    January 24, 2009

    OK, dumb question: why is radiation oncology in the basement?

    Easy. Because rad onc facilities require very thick reinforced walls lined with lead, which is much easier to do in a basement than above ground.

  3. #3 Blake Stacey
    January 24, 2009

    I was guessing that shielding would have something to do with it. Hooray — I learned something today!

    (And now that that’s out of the way, time to drink.)

  4. #4 khan
    January 24, 2009

    In a weird way, your hospital basement reminds me of both the back half of the Huntsville Times facility (where my father worked when I was a young’un) and the zeroth floor of MIT. Neither of those locations have a morgue, however, to the best of my knowledge.

    Actually, newspapers do have ‘morgues’.
    ———————————————–
    http://www.merriam-webster.com/dictionary/morgue

    2 : a collection of reference works and files of reference material in a newspaper or news periodical office

  5. #5 llewelly
    January 25, 2009

    Now wait a minute here. Underground tunnels can only mean one thing … secret underground hideouts. And secret underground hideouts can only mean one thing – dastardly conspiracies! Somewhere, near your hospital, there must be a command nexus of Big Pharma. Or maybe it’s only Dr. Horrible.

  6. #6 MikeMa
    January 26, 2009

    Connie Willis wrote a scifi-ish novel called Passage featuring a hospital where getting lost between all the old/new building connections was indeed the rule. She also allowed her docs to use it as an excuse to miss meetings.

    Very imaginative story too BTW.

  7. #7 Adam Cuerden
    January 28, 2009

    This is wildly off-topic, but, actually, my local built-two-years-ago supermarket uses a tube system for sending cash from the registers to a back room.

  8. #8 SimonG
    January 28, 2009

    There’s a small clothes shop where I live that still uses pneumatic tubes. They don’t have registers at all: payment goes in the tube, and change and receipt comes back. (They do have credit-card terminals now, though.) It’s a lovely, old-fashioned sort of place.

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