AUGUST 18, 2000.
General questions about hospital design
Participating in hospital design is a very specific pursuit in terms of architectural practice. How did your firm become involved in this field? What previous involvement did your firm have in hospital design?
My uncle, Eugene Larose, worked on the Sacred Heart Hospital when he was a young architect. Eventually he opened his own practice and became the architect for various hospitals, such as the Sanatorium in Robertval in the early 40s, and one in Hull, Quebec.

My first job after graduation was with the firm of Charles David who was commissioned to design a hospital for the veterans who were just returning from the war. I was working with him there and became accustomed to hospital design and decided I liked that kind of work. We worked for a full year on the Veterans’ hospital which went out for tenders but was never built.

After that I worked for some other firms and eventually I came to work with Eugene Larose, my uncle. In 1948 he received a mandate from the federal government to revamp and extend the Montreal Veterans’ Hospital which was located on Queen Mary Road, just across from the St. Joseph’s Oratory. It was sold to the provincial government and became the Hospital Cote-des-Neiges. (ed. Note: It is now actually the Institut de Geriatrie de Montreal.) It was formally a religious hospital for the blind built by the Grey Nuns, but during the war it was used as a wireless school. In 1948 Eugene got a mandate to add an important wing to the building and renovate the whole thing, and I did much of the work myself.

The stair towers on this building are quite distinctive.
These were added later; they were not built by me. They were added by another architect for security. But, we did all the work [on this hospital] and made all the plans, but they did not go out to tender. There was the Korean War and the federal government decided to cut the bill. They amended that eventually, and later on they built a new tower at Sainte-Anne-de-Bellevue, so instead of revamping and extending that one at Queen Mary they sold it to the Quebec Government for one dollar and the government made it into the Cote-des-Neiges Hospital for older people. (Which is now the Institut de Gériatrie de Montréal.)

Eugene had a mandate to design some extensions at the Robertval hospital, and I started to work on that and to familiarise myself more and more with hospital design. I had a personal contact and was able to obtain the mandate to build a new hospital in St. Jean, Quebec. I had been interested in hospital design since I worked with David, and I had always followed design in the United States through magazines. That’s why I became more and more involved in hospital design. I like it since it takes a lot of research and also there is always something new on the market--new equipment, new procedures--and in the United States they have so many resources that they are a very good source of information.

I got a mandate to design the Universite de Montreal faculty of medicine and medical center, which was to be built on Decelles Street where the former building of the Ecole des Hautes-Etudes is now. We made a perfect design on that piece of land. The hospital was to be dedicated to teaching. I got the O.K. from Mr Jean Lesage, the Prime Minister of the Province of Quebec, and from the Board of Governers of the University of Montreal, but someone flagged the project somewhere in Quebec and it was not built. The government changed and the project was abandoned.

During the University of Montreal Medical Centre design period, the team was sent to Europe for a survey of some medical facilities. A group, representing the new University of Sherbrooke Medical Centre, was invited to join us in order to benefit from our own researches on that subject.

At our return to Montreal, the Dean of the Sherbrooke Medical School invited me to be commissioned as their Consulting Architect. I enthusiastically accepted the challenge.

They wanted to use a structure which was designed during the Duplessis Regime to be a 1200-bed psychiatric hospital. When it was decided that psychiatric patients should be housed in separate departments of other hospitals, rather than in one large building, the building was left empty. It was 600 000 square feet or more, and 10 storeys high. The university of Sherbrooke bought the building for a dollar and decided to make it a medical centre.

I was invited to take over the design from an American consultant. I designed the Sherbrooke medical centre nearly alone. Four hundred thousand square feet of new facilities were added to the existing structure. It was projected to be 500 beds, but only 365 were implemented at that time. It is a school of medicine and a hospital.

My St. Jean hospital was the first hospital in Quebec where I used a double corridor for each nursing unit instead of using one corridor with rooms on both sides. I put all the services in the centre and two corridors with rooms on the exterior sides. I used the same pattern for the medical centre in Sherbrooke.

Later on I got a mandate to add some new facilities to Notre Dame Hospital for emergency and for radiotherapy and in 1983 there was a competition for architects to design the extension for the Royal Victoria hospital that resulted in the addition of the Centennial Wing plus a lot of other smaller interventions elsewhere on that campus.

In hospital design, is the autonomy of the architect diminished because of the highly technical nature of modern healthcare, for which doctors are the only true expert consultants? To what extent were your design decisions made or influenced by the input of medical professionals of the Royal Victoria and the MUHC?
There is a certain constraint; you contribute to build the program with the team of doctors, nurses and administrators, but the constraint is not terrible. It gives you a certain approach. You have to follow and establish a pattern of usage. The building has to be practical and efficient. Aesthetics matter, and all the modern equipment which goes in must be considered.

You have to be up to date.

Up to date, yes. I did the first double corridor in St. Jean, Québec. I found it very interesting because you shorten the distance the nurse has to walk to see patients. You have all your services in the middle. You have the nurses’ station at the entrance. You control the entrance and with rooms on both sides you shorten the distance. In the old system you have the nurses in the middle and a long corridor to reach both ends.

How do you find working with doctors?
I like it. Sometimes some of them are narrow-minded. We have to be careful. We have to listen to all of them and then balance one against the other. It helps to have someone at the administration level to back you up to make the planning realistic. The autonomy is limited, but if the project is intelligently organized then it is pleasant to work. The first thing is to make a good, realistic program. Sometimes there are people who do only programming in the ministry of health, but they don’t understand that you need some elasticity in the square footage to fit everything together properly.

Questions about the pre-design stage of the centennial pavilion
By what process did the Centennial Pavilion Project come to your attention, and why did it interest you? Please describe the process by which you came to be selected as designer of the Centennial Pavilion (open bid, invitational bid, etc.)
The government advertised in the paper for an offer of services, and five offices responded. Regarding the production of competition drawings, we actually did not have to do any. Actually, there was just a form that had to be filled out. We had to present photos of our former projects, a list of similar projects, the cost and the names of people working with us, as well as CVs of the people on our team. Since the project was awarded in this manner, it is critical to attract good expertise, and maintain it on your staff.

Is this process typical of hospital projects?
Yes it is typical. It is changing a little bit now. Still, reputation is very important. That is why sometimes younger firms want to join with senior firms, to gain from their reputation. In this case, the Royal Victoria Hospital had collected money and invited our firm to present an offer of services. We were to present an architect and engineer team to do the work. There were about 5 contenders, but we won the competition.

The first thing that was ready was the extension to the Allen Memorial, so we built that wing which links the old stable, which we renovated later. When I designed that extension I had wanted to use stone, but the budget was not large enough so we were forced to use brick. I argued that the hospital is an historic landmark and that stone should be used. In the end we reached a compromise: brick walls for the back side which is not seen from the street, and stone for the other facades. The stone used is artificial stone. Renaissance stone was used for the part between the Allen Memorial and the old stables.

In the meantime Royal Victoria Hospital was finishing the programming for the rest of the project.
Historically, the Royal Victoria Hospital stands as a social, institutional, and architectural landmark in the city of Montreal. As an architect, how did you feel about adding to the work of some of Montreal’s most important designers, such as Ross & MacDonald, and Hutchison & Wood? In what ways did you hope your design of the Centennial Pavilion would add to this legacy?
We had to respect the existing building. Our project included the Centennial Wing and an extension to the Allen Memorial, renovations to the Women’s Pavilion and the Hersey Pavilion, and we were supposed to rehabilitate part of the front wing of the original building, the one along University Street and Pine, but there was not enough money. As far as the history goes we were aware that our efforts would affect several very historical buildings.

How much of the work you describe actually took place?
Part of the project. The budget was 25 million dollars in the beginning for the whole project, and with the inflation and adjustments it went up to $ 35 million. The Centennial Pavilion cost $22 million, while the Allen Memorial cost $2 million. We didn’t do anything to the Ross pavilion except the connection to the Centennial Wing.
So you were everywhere on the site then.

How much did you know about the history before you started work?
Not much. I obtained some documentation. The person in charge at the Royal Victoria was Charles MacDougall who is a hospital administrator. He worked at the Royal Victoria for about 10 years and had a very good sense of the history. Actually, the program was made by a professor of philosophy, Shalom Glouberman, Ph. D.

Questions of site
Though it was originally a very open site in 1893, a century’s worth of development has severely limited the available sites at the Royal Victoria for new construction. In these terms, the ‘prime’ construction spots were used for the original buildings, Ross, Women’s’ Pavilion, and other historical buildings. To what extent was this a disadvantage for the Centennial Pavilion Project, and how was the site for the Centennial Pavilion ultimately determined? Did the close proximity of the surrounding buildings result in difficulties during construction?
An extension was added in the 1950’s where a more modern architectural style was used. The exterior envelope was made of lime stone slabs, the rest was cut rough stone. When we came to design the Centennial Pavilion there was a small building on the site which was the Interns’ Residence. One approach was to keep the interns’ residence, build eastward and keep an open court in between. But we would have had to demolish the laundry building. In the end, we had to demolish the Interns’ Residence, since doing laundry at the Montreal General or relocating it below ground were not seen as acceptable solutions. Unfortunately the laundry blocks the emergency entrance to the Centennial Pavilion.
Did you perform site studies for this project, or did the governing body of the Royal Victoria specifically instruct you where to put the building?
We did the studies ourselves, in close relation with Royal Vic. Hospital Building Committee, but we had to connect certain services, for example the surgical wing has to be next to the intensive care unit. There were a lot of constraints. The site we chose was the most practical in relation to the services we needed to connect.
From the architect’s point of view, the Royal Victoria Hospital site has historically been challenging given its steep slope and the presence of solid rock strata near the soil surface. How did these site conditions affect your planning of the Centennial Pavilion, and its construction.?
We had the slope of the mountain and the rock to dig, and the access to the emergency was difficult because there were not many choices for its location, especially because they did not want to demolish the laundry. These factors combined to make work on this specific site quite challenging.

Questions of design
Programmatically, what is the mandate of the Centennial Pavilion in terms of its functioning within the Royal Victoria Hospital? How did you approach the layout of spaces within the building?
As I said, we had a program established by a committee of administrators, doctors and users. We took the program and we went over it with the committee to make it more realistic. For example, we have provided for additional floors to be added if necessary. The basic function of our work was to complete the emergency facilities. The existing emergency was not functioning well. The Centennial was to be a new, larger, modern facility. The rooms are big enough that in the case of a major emergency they can accommodate more than one person at a time in each room and treat six people at one time. These days the emergency and trauma unit is the true foundation of any hospital.

Passageways and links between different pavilions have always been critical at the Royal Victoria. Given the central location of the Centennial Pavilion, how did you address the high degree of importance of easy circulation within and outside of the building, especially access for emergency services on the University Street facade?

We realised that we could never achieve a perfect circulation pattern because the additions to the original hospital had been scattered all over the place and connecting them was very difficult. Of course, it is much easier to start with an empty site.

Given the wide variance of architectural styles present in the buildings of the Royal Victoria, from the original buildings by Saxon Snell to Barrot, Marshall, Montgomery and Merrett’s new wing of 1955, how did you determine a stylistic approach to the Centennial Pavilion?
We had to consider what we were doing to accommodate the site and we used rough stone to go with the existing buildings. They are an “ensemble.” Having the sloped copper roof on the penthouse provides a relationship with the existing buildings in terms of materials, although overall the Centennial is a modern design.
So it is a material approach.
Yes. There was a mix of cut stone. Some was rough and some was smoother. We discussed with the City of Montreal that it would be good to relate the exterior facades of our building to the two pavilions at the back. It was a low priority for the budget and cost 500 000 dollars more, but the committee accepted the proposal. The stone is much better than brick or pre-cast stone blocks. It is limestone from Deschambault, Quebec. The Surgical Wing was built with Queenston Lime Stone in 1952.
And regarding the roofline of the Centennial Pavilion?
We wanted to make it modern, but with a certain relationship with the other buildings. That is why it is a green colour. On the penthouse level there are the mechanical services.
Is there one aspect of the Centennial Pavilion of which you are particularly proud?
I am proud of the way we handled the exterior of the building. As for the interior, we managed to provide for all the services in the basic care unit. The circulation was a challenge which we have successfully solved.
If you could change one thing about it would you remove the laundry services?
In 1894, Saxon Snell described the planning of the original hospital buildings as ‘the most difficult task he ever had to perform’. How does your experience compare with his?
It’s one of the more difficult tasks I have had in the field of hospital design because the local conditions are so difficult. To respond to all the needs at the same time was not easy. This difficulty was reflected in the large number of preliminary studies made before we even began the design.