Assembling atmospheres, encountering care: Risk, affect, and safety in the cystic fibrosis clinic

Abstract

This paper explores the design of hospital environments, in order to investigate how issues of infection control, spatial layout, and embodied practices intersect in the accomplishment of ‘care-ful’ geographies. Specifically, we trace how the material environments of three UK cystic fibrosis (CF) clinics are assembled in order to orchestrate routines that minimise the risk of cross-infection between patients and safeguard their wellbeing. Our analysis of these clinics, derived from interviews with staff and patients and ethnographic observation, reveals the importance of environmental factors in brokering affective atmospheres that can alleviate patients’ anxieties. Theoretically, we draw on Ben Anderson's understanding of how affect works as, simultaneously, an object-target, bodily capacity, and collective condition, in order to draw out the architectural atmospherics of the CF clinic. That is, we first report how clinic staff anticipate cross-infection risks and configure the physical environment in order to minimise these risks. We then describe the embodied practices of patients as they move through hospital spaces in ways that protect themselves, and others, from cross-infection. Finally, we analyse how this choreography of material environments by staff and the movement of patients’ bodies combine to evoke a shared understanding of the clinic as a safe space, in contrast to perceptions of the hospital as a threatening environment. Our focus on the affective atmospheres of the CF clinic allows us to develop an in-depth analysis of the role of materialities, mobilities, and design in the social construction of risk, especially in a post-COVID pandemic age.