Sight is perhaps one of the easiest senses to reach in the modern history of hospitals. We have colour photographs, artwork, architectural drawings, film, leaflets, posters and extensive other visual sources. It may be partly for this reason that sight is also one of the most extensively addressed senses in modern history. This is not to agree with the long-dismissed – or at least critiqued – claim that the West become a predominantly visual culture in the modern period. New technologies have undoubtedly placed greater emphasis on the visual, including in medical diagnosis, and sight has long been culturally conceptualised as a ‘higher’ sense. However, this has not been at the total expense of other senses. It is well established that sight cannot be separated from other senses and that other sensory experiences have retained their importance in people’s lives, and in medical diagnosis. Nonetheless, for many people, vision is an important and often dominant sense.
In the light of these claims, it is perhaps not surprising that many attempts to improve hospital aesthetics have been visual. The Wellcome Library is currently cataloguing an extensive hospital arts collection that reflects the growing interest in this field, and its professionalization, in the late twentieth century. Hospital architects have also never neglected the importance of the visual. Despite the general perception of hospitals as unaesthetic, the history of hospital design tells a different story. Late twentieth-century writings on the need to ‘(re)humanise’ unaesthetic modernist and functionalist hospitals had some grounding in general terms, but there are also many examples of highly aesthetic and ‘humanistic’ examples of modernist hospital design. In deeper history, holistic care – including its religious dimensions – has always involved some aspect of visual design. Most recently British hospital architects have drawn inspiration from Scandinavian design, with its focus on light and air. While not all hospitals could be built from scratch, the influence of these trends is often evident on a smaller scale – for example, in the form of a new hospital atrium.
Many visual interventions in hospitals have revolved around nature, whether in the form of arts or views of (and access to) gardens. Roger Ulrich’s famous publication in Science in 1984 on the impact of viewing nature, for patient recovery, fuelled an evidence base for the visual side of holistic healthcare. The colour green, with its natural connotations, also has an interesting history within hospital colour psychology. In addition to questions about the extent, success or failure of these interventions, there are very interesting historical questions around this kind of visual culture and the meaning of certain images. Why has nature been so often constructed as the visual symbol of wellbeing? Why has it been represented as a ‘humanising’ force, but technology as a ‘dehumanising’ one? Which images of nature have been used to promote holistic wellbeing, and which have not? Does a picture of a tree, or an artificial plant, fulfil the same sensory role as real nature (without the smell of the tree, or the sound of wind rustling through its leaves)?
There are also many practical elements to the visual in hospitals. The increasing use of colour as a ‘wayfinding’ device, particularly for the elderly, is an interesting trend in visual design. The Wellcome Collection’s current exhibition reminds us of the importance of graphic design in public health. Notices, signs, leaflets, and information boards also have a design history. Medical geographers have long shown the value of reading hospital spaces and architectural plans, for the ways that they reveal hospital dynamics and power relations. Other practical – but important – aspects of sight in hospital relate to the presence of other people, including the work of staff and the visibility of illness. We should not ignore these ostensibly more prosaic aspects of sensory history.
The perception of sight is no more objective than any other sensory experience. People have different visual abilities and see in different ways. As John Berger’s excellent and influential work on art history Ways of Seeing argues, the viewer’s belief also affects how they see and the meaning that they give to sight. We know the importance of signs and symbols from art history, semiotics and anthropology, and we must incorporate some of these approaches into histories of the visual senses in hospital. It is also an active and engaged sense: many people in hospitals have the ability to direct and close their eyes. At any given time in the same place, each different person may either be focusing their gaze on different things, or may be looking at the same thing from different perspectives (literally and figuratively). These differences in perspective, and perception, must form part of any history of seeing in hospitals. While we can write a history of what a hospital looked like, or find a photograph of it, this is only one aspect of a sensory history.