The design of the hospital proposed by UCSF is dynamic. It does not mean that it will be built

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Considered only as architecture, the hospital that UCSF wants to build on its Parnassus Heights campus is really promising. It is a provocative but humane attempt to create a unique place of healing within the ridge line.

But when the setting is as complex and contested as this one, the inventive design can go no further.

That’s the tension right now as the university seeks to build a large medical facility that would join an already overcrowded campus on the side of Mount Sutro, just two blocks south of Golden Gate Park. Even the architects admit their mission is daunting – squeeze a 15-story, 870,000-square-foot hospital into a small site with single-family homes to the east and an older, forbidden hospital slab to the west.

“It is not an easy task to marry a building of this scale with the neighborhood that exists,” said Jason Frantzen, senior partner at Herzog & de Meuron, the architectural firm that designed the project.

The Swiss company is no stranger to the region: it also designed the de Young Museum at the Music Concourse in Golden Gate Park. Born into controversy, with a 144-foot-tall observation tower that infuriated many critics, the museum that opened in 2005 is as good as any building added to San Francisco so far. this century.

The proposed hospital also has design twists.

It would rise nearly 300 feet at the corner of Parnassus Avenue and Medical Center Way, the eastern edge of the congested 107-acre campus, replacing a mental institution on the steep triangular plot. But rather than appearing as a single overwhelming mass, as it did with the neighboring Moffitt Hospital in 1955, this would appear almost as three structures stacked on top of each other.

The five-story base would be huge, with the first two floors pulled out of Parnassus Avenue to create a spacious main entrance. The four floors above would be covered with glass and would rise in the middle of a large terrace laid out by James Corner Field Operations, the landscape architect firm also realizing the Tunnel Tops park which opens in April in the Presidio.

And in addition this? Six broad floors that would resemble a blunt pagoda, with generous eaves to shade the rooms inside. The side facing east, towards a residential area, would have a jagged profile to be less monolithic.

Other design elements are still evolving. Renderings show glazed terracotta enveloping the lower and upper parts of the building, but that could change. The idea is an earthy look, rather than metal panels or even more glass.

The project would include internal connections to Moffitt and the adjacent Long Hospital, which UCSF built in 1982. In addition, Moffitt would be brought up to current seismic standards.

The newcomer would be intrusive, no doubt; As stated in the environmental impact report published last month, the proposed project “would contrast sharply in height and scale” with the Cole Valley neighborhood to the east.

“We understood that there were concerns about such a building and its impact,” Frantzen said. “He has to be tall because of the demands he has, so he needs a careful response.”

This understanding is part of what defines the work of Herzog & de Meuron, who on this project is the “design consultant” for the reference architect, HDR. There is an uncompromising rigor that can be difficult, as with de Young. But it’s also imaginative – like de Young’s truly public perch above the park.

A rendering of the new hospital that UCSF is looking to build on its Parnassus Heights campus. This perspective is from the north, with an existing medical building to the right.

Herzog & de Meuron in collaboration with HDR

With the proposed hospital, the practice understands that it is a structure experienced in very different ways depending on where you are. The base is designed to relieve the claustrophobic setting along Parnassus Avenue, while the pagoda-shaped top would energize the campus skyline. As for the relatively narrow stack of floors in the middle, their large terrace would serve patients and the public.

This is what makes the design so fascinating. But the hospital is only part of UCSF’s expansion plans – and that’s what is fueling the current tension between the university and its neighbors.

The medical campus dates back to 1898 and has grown to the point of stopping just one block from Golden Gate Park. There are laboratories and classrooms, parking garages and a utility plant.

Resistance to this growth intensified in the 1970s, which is not surprising given that a neighboring neighborhood is the ultra-liberal Haight-Ashbury. Finally, in 1976, UCSF agreed to cap the size of the Parnassus Heights campus.

This truce was reaffirmed no later than 2014 by the UCSF. But the updated plan for Parnassus Heights that UC’s board of directors approved last year would allow an additional 1.05 million square feet on top of the 3.55 million square feet previously allowed.

Three lawsuits are now challenging the plan’s environmental impact report, citing a litany of concerns, including impacts on transportation and the shadows that would be cast on parks and playgrounds. Beyond that, however, is the frustration of a state institution deciding to dispense with 45 years of local precedent.

“Pledges have been made by them (UCSF) several times, and then in 2020 it all goes out the window,” said Dennis Antenore. A former planning commission, Antenore has been part of an advisory group involving UCSF and its neighbors since 1991. “They said they were no longer bound by (the 1976 agreement).”

In the new plan, UCSF cited everything from increased patient numbers to new research grants to explain the decision to relax the boundaries and “meet these critical space needs.”

UCSF Parnassus Campus proposed a plan that would replace the existing medical buildings at Parnassus and Medical Center Way.

UCSF Parnassus Campus proposed a plan that would replace the existing medical buildings at Parnassus and Medical Center Way.

Santiago Mejia / The Chronicle

Realistically, there are good reasons to relax the long-standing boundaries of one of the Bay Area’s most important medical centers. The world of healthcare has changed dramatically during this time. Technological requirements, regulatory limits and patient expectations too.

The new hospital, for example, would be 100 feet taller than the neighboring 1955 Moffitt Hospital, even though they both have 15 stories, in order to have room under floors and above ceilings for the hospital. wiring and conduits adapted to today’s medical technology. The standard patient room would measure around 300 square feet, so it could easily be adapted into an intensive care room at some point in the future. Moffitt’s patient rooms measure 180 square feet.

Sadly, by arbitrarily deciding that the new times demand a new approach, UCSF has fueled the resolve of already stubborn watchdogs to fight back in court. The design of the new facility is a compelling glimpse into what urban hospitals can become. But even the best architecture alone cannot cure frayed relationships.

John King is the San Francisco Chronicle’s urban design critic. Email: jking@sfchronicle.com Twitter: @johnkingsfchron

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