Theodore, David Michael (Author)
Hays, K. Michael
Harvard University
Hays, K. Michael
Brandt, Allan M.
Picon, Antoine
Galison, Peter L.
Edition Details: Advisor: Picon, Antoine, Galison, Peter L; Committee Members: Hays, K. Michael, Brandt, Allan M.
Physical Details: 351 pp.
Language: English
This dissertation provides an account of how computing left behind its origins in academic and military research to become part of the hospital's equipmental setting. I examine the efforts of reformers, including administrators, planners, architects, and computer consultants, to provide appropriate accommodation for modern biomedicine. I explore three stories in order to untangle the admixture of architecture, medicine, and computation as they intertwined through a mutual engagement with automation, operations research, cybernetics, and biomedical research in the postwar hospital. In Boston, pioneering research consultants Bolt Beranek and Newman collaborated with the Massachusetts General Hospital on an experimental total information system known as the Hospital Computer Project. In London, architects Llewelyn Davies Weeks used computer algorithms to help design Northwick Park Hospital. And in Canada, the Montreal Neurological Institute adopted computing to transform its expertise in clinical brain imaging research. When possible, I emphasize specific computers, arguing that attention to the presence of the machine itself contributes to our understanding of hospital life. In examining hospital reform after the Second World War, I claim that the hospital building must be conceived as something other than a physical representation of medical knowledge, first, because the new computer-oriented hospital practices often took place in buildings not purpose-built to accommodate them; and second, because reformers who used computation to design and construct new hospitals sought an architecture that would accommodate a state of permanent progress. The resulting buildings were deliberately planned to provide only a "loose fit" to biomedical knowledge. Hospital computer information systems and hospital architecture developed homologous designs meant to forestall obsolescence and self-adjust to growth and change. I conclude that the failures and reversals these optimistic reformers encountered indicate the emergence of a stable sociotechnical configuration, a set of places and practices intertwined with problems that could not be overcome through improved designs, more diligent scientific research, or through calling for more compliant users, especially nurses, or re-training them. Finally, I posit the lattice diagram as the best image of the forces that linked architecture, medicine, and computation together in the drive towards a new hospital.
...MoreDescription Cited in Dissertation Abstracts International-A 75/10(E), Apr 2015. Proquest Document ID: 1557744929.
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