Sound medicine: studying the acoustic environment of the modern hospital, 1870–1970

Abstract

The twentieth-century hospital encountered two categories of sound that appeared troublesome. First was a kind of noise generated by city life, and second was a kind of soundscape generated by hospital life. In both cases, the acoustic environment was described and notated as an effect on patients, who, ill and immobile, were subject to sounds in a way that put their health and recovery at risk. In both cases, the solution to sound problems in the hospital was seen to be cultural and material, not medical. The difficulty was that physicians had no especial training to address the effect of sound on patients’ bodies. Sound and noise escaped the remit of medical expertise, and hospitals instead relied on a weak disciplinary injunction to silent comportment. This left sound as a matter for the medical environment rather than for medical intervention. In short, sound medicine was architectural.This paper looks at the twentieth-century modern hospital as an institution with particular acoustic environments, modified and shaped by architectural responses to the perceived problem of sound. I explore the emergence of noise on the inpatient ward as an architectural research topic, especially in the ground-breaking studies of the Nuffield Provincial Hospitals Trust (ca. 1955), and the identification of the emergency ward as the hospital’s signature acoustic environment. Using published studies of architectural acoustics, prescriptive advice from hospital specialist architects, and evidence from documentary films, I argue that the engagement with sound is an underemphasised yet key architectural characteristic of the modern hospital.