The design for UCSF’s proposed hospital is dynamic. That doesn’t mean it will get built

The proposed hospital also contains designs.

It will rise nearly 300 feet at the corner of Parnassus Street and Medical Center Road, the eastern edge of the crowded 107-acre campus, to replace a psychiatric institute in the steep Triangle parcel. But rather than looming as one overwhelming mass, as is the case with the adjacent 1955 Moffett Hospital, this building would appear roughly as three structures stacked on top of one another.

The five-story plinth would be massive, with the first two floors pulled back from Parnassus Street to create a spacious main entrance. The four floors above will be covered in glass and rising from the middle of a wide balcony landscaped by James Corner Field Operations, the landscape architecture firm is implementing Garden Tunnel Tops, which opens in April in Presidio.

And on top who – which? Six spacious floors look like a blunt pagoda, with generous eaves to shade the rooms inside. The side facing east, towards a residential area, would have a rough shape to be less than a monolith.

Other design elements are still evolving. Renderings show the glazed terracotta that wraps the lower and upper parts of the building, but that could change. The idea is an earthy look, not metal panels or more glass.

The project will include internal connections to Moffett and the adjacent Long Hospital, built by UCSF in 1982. Also, Moffett will be upgraded to current seismic standards.

The newcomer will be intrusive, no doubt; As stated in an Environmental Impact Report released last month, the proposed project “will contrast sharply in both height and size” with the Cole Valley neighborhood in the east.

“We understand that there are concerns about such a building and its impact,” Frantzen said. “It has to be large given its requirements, so it needs a careful response.”

This understanding is part of what defines the work of Herzog and de Meuron, who in this project is considered the “design advisor” to recording engineer, HDR. There is a relentless rigor that can be challenging, as with De Young. But it’s also fictional – like the really generic De Young perch above the park.

With the proposed hospital, the company understands that this is a structure that is being tried in many different ways depending on where you are. The plinth to mitigate claustrophobia has been positioned along Parnassus Street, while a pagoda-like summit will enliven the campus skyline. For the relatively narrow floor stack in the middle, its wide balcony serves the sick and the public.

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

The medical campus dates back to 1898, and has grown to the point where it stands just a block from Golden Gate Park. There are laboratories, classrooms, parking garages and a utility factory.

Resistance to this growth intensified in the 1970s—no surprise, given that one neighborhood neighborhood is super-liberal Hight Ashbury. Finally, in 1976, UCSF agreed to limit the size of the Parnassus Heights campus.

This truce was recently confirmed in 2014 by UCSF. But the updated plan for Parnassus Heights approved by the University of California’s board of governors last year would allow another 1.05 million square feet on top of the 3.55 million square feet previously allowed.

Three lawsuits are now challenging the environmental impact report of that plan, citing a range of concerns including the impacts of transportation and shadows that will be cast on parks and playgrounds. Moreover, there is frustration with a government institution’s decision to lay off 45 years of domestic precedent.

“They (UCSF) have made pledges over and over again, and then in 2020, it all goes out the window,” said Dennis Antenor. Antenor, a former planning committee, has been a member of an advisory group involving UCSF and its neighbors since 1991. “They said they weren’t bound by it (the 1976 agreement) anymore.”

In the new plan, UCSF cited everything from increased patient numbers to new research grants in explaining the decision to ease limits and “meet these critical space needs.”

Realistically, there are good reasons to loosen the long-standing restrictions on one of the most important medical centers in the Gulf region. The world of health has changed immeasurably during this time. So you have the technological requirements, regulatory constraints, and patient expectations.

For example, the new hospital would be 100 feet taller than the neighboring 1955 Moffett Hospital, although both are 15 stories, in order to provide room below floors and above ceilings for wiring and ductwork appropriate for current medical technology. A standard patient room is about 300 square feet in size, so it could easily be adapted to an intensive care room at some point in the future. The patient rooms at Moffett are 180 square feet in size.

Unfortunately, by arbitrarily deciding that the new age required a new approach, the California-San Francisco Federation had stoked the design of already stubborn regulators to fight back in the courts. The design of the new facility is a compelling look at what urban hospitals could become. But even the best architecture can’t heal strained relationships on its own.