Annmarie Adam's book Medicine by design (2007) examines how hospital architecture shaped and responded to changing ideas about medicine and its place in the urban realm. It uses the development of the Royal Victoria Hospital in Montreal (1893–1943) as its central case study.
The book is an excellent source of information for anyone interested in relationships between building forms and the communities in which they are embedded.
One item of particular interest was the changing relationship between doctors and nurses.
In rough terms, hospitals were originally conceived as a place where nurses—all women—would look after sick people, particularly those who could not afford a doctor's services. The focus was on comforting the sick; there was no firm expectation that people with profound health issues could be cured.
With advances in medicine, this expectation began to change and people began to look to hospitals for healing. That meant doctoring and doctors were all men. Thus, doctors took on an ever-increasing role in hospital function. Hospital architecture had to respond.
The response took many forms. Hospital wards, in which nurses looked after sick patients, were joined by operating theaters, where doctors performed surgeries, which were often viewed by an audience of doctors in training.
Training for nurses and doctors also required provision of lodgings. The nurses' residence was designed to seem domestic. External details evoked popular, middle-class domestic architecture of the day. The interior was fitted out with a homelike foyer, living room, fireplaces, and parlours. The emphasis on domestic appearances was thought proper since women—even working women—were still seen as essentially domestic creatures.
The intern's residence was fitted to reflect notions of "masculinity and power" (p. 87). For example, the residence was provided with a billiards room. Billiards was a popular activity among aristocratic men and was thought to cultivate a manly capacity for competition and strategizing.
By contrast, the nurses' residence was provided with a piano, to allow the women to practise artistic talent and an ability to communicate emotional sensitivity.
Adams's history of hospital architecture provides, among other things, an effective illustration of how gender has been conceived and designed into the built environment.